We report the treatment of a young male who reported facial pain secondary to an oral cancer recurrence involving the trigeminal nerve root with severe facial pain and headache. 
Our patient had a surgery for buccal mucosa cancer with primary closure in 2018, and he reported pain in the distribution of the mandibular nerve 2 weeks after the surgery. His reports of pain were dismissed as being secondary to the acute surgical phase, and he was put on analgesics and neuropathic pain medications for pain relief with no change in his pain. 
He came to our institution after imaging was done for the pain, which revealed metastasis involving the mandibular division of the trigeminal nerve. We initiated chemotherapy and concomitant radiotherapy for the disease process. We initiated counselling as well for him and his family in view of his distress and frustration. Clinical examination revealed a focal patch of numbness over the right lower jaw and front of the cheek. The masseter reflex was intact.
We performed a percutaneous radiofrequency denervation since the Ganglion was intact, and counselled the patient about the possibility of denervation hypersensitivity. We applied three cycles of ablation at 70 degrees for 90 seconds, using fluroscopy to guide the needle position into the foramen ovale. We used sedation and monitoring to help with intraoperative pain. 
The patient tolerated this procedure well with complete relief of pain. This abstract discusses challenges in dealing with orofacial malignant neuropathic pains.owing to the innervation of the trigeminocervical complex.

THE USE OF RADIOFREQUENCY THERMAL DENERVATION OF THE TRIGEMINAL GANGLION FOR MALIGNANT TRIGEMINAL NEUROPATHY: A CASE REPORT