Treatment of malignant pain of the head and neck.

The treatment of pain due to malignancy in the head and neck is difficult, and the pain doctor must take a special responsibility in selecting the appropriate treatment. Specialized and often combined surgical procedures may still offer the best chance of relief, particularly when tumours involve the paranasal sinuses and the petrous bone. Peripheral and central destructive procedures can prove effective, and perhaps thalamotomy is deserving of greater usage. Chronic intrathecal analgesic administration can undoubtedly prove effective, and while the unwanted features may yet have to be established, it provides a welcome additional option in the management of pain in this difficult area.