Great Auricular Neuralgia: Case Series.
BACKGROUND/OBJECTIVE
The great auricular nerve (GAN) arises from C2-C3 and provides innervation over the skin in the pre-auricular region, jaw angle, posteroinferior pinna, and mastoid. Although damage to the GAN has been reported following trauma or procedures nearby this nerve course, neuralgia of this nerve is uncommon with knowledge based on a handful of case reports in literature. The objective of this study is to describe the presentation, treatment, and outcome of 13 cases of GAN neuralgia.


METHODS
Case series. Retrospecive review of charts from 1994 to 2018 with diagnoses: "auricular neuralgia," "auricular neuritis," or "auricular neuropathy." We included subjects with neuralgic pain within the distribution of the GAN, and excluded patients with atypical facial pain, GAN neuropathy, or unclear etiology.


RESULTS
Of 79 charts, 13 patients met criteria (age at onset 11-59; 11 women, 2 men). Pain was most often described as paroxysmal stabbing provoked by: turning the head (n = 7), touching the neck (n = 5), neck position during sleep (n = 2), jaw movement (n = 2), and other (n = 2). Seven patients received GAN blocks: all noted dramatic improvement in pain, including 3 who continued to receive serial blocks at our institution successfully for the next 2 to 5 years. Two patients successfully transitioned from GAN blocks to GAN stimulators. One patient with GAN lymphoma had resolution of pain following GAN resection.


CONCLUSION
GAN neuralgia should be considered in the differential for periauricular pain. GAN blocks or stimulators may be helpful for pain management.
['Duvall|Jaclyn R|JR|', 'Garza|Ivan|I|', 'Kissoon|Narayan R|NR|', 'Robertson|Carrie E|CE|']
D000328:Adult D002572:Cervical Plexus D002648:Child D004599:Electric Stimulation Therapy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009407:Nerve Block D009437:Neuralgia D019635:Neurosurgical Procedures D012189:Retrospective Studies D016896:Treatment Outcome
neuralgia great auricular nerve nerve block neuropathic pain peripheral nerve stimulation red ear syndrome