The Superficial Cervical Plexus Block with the Auriculotemporal Nerve Block for Breaking the Refractory Pain Cycle of Malignant Otitis Externa and Skull Base Meningitis

Abstract

Abstract Pain can be a severe and distressing symptom in conditions such as malignant otitis externa (MOE) with the associated skull base meningitis and even more following the debridement surgeries done for the same. It can be refractory to conventional therapies, including weak opioids, nonsteroidal anti-inflammatory drugs, and antineuropathic medications. Breaking this cycle of pain is very important in such cases to achieve good pain control and treat the psychological distress of the patient. Since there is a lack of literature for achieving satisfactory pain control in such cases, we successfully adopted a novel approach to break the pain cycle by employing the superficial cervical plexus block and auriculotemporal nerve (ATN) nerve block as the area of pain was in the distribution of these two nerves.