Sphenopalatine Ganglion Block in Houston TX

Highly effective and with minimal risk, Sphenopalatine Ganglion block is one of the most successful methods to treat acute head and facial pain. With medical field attaining greater technical proficiency, the procedure has become minimally invasive providing both immediate and long-term relief and life-long freedom from the nuisance of daily drugs.

What is Sphenopalatine Ganglion Block?

Sphenopalatine Ganglion block is an outpatient treatment where a numbing agent is administered through transnasal, transoral, or infrazygomatic procedure to inhibit somatic sensory afferents, parasympathetic nerves, and sympathetic neurons in the pterygopalatine fossa behind the nasal cavity. This blocks pain signals from reaching to the brain, and patients experience significant relief.

Why Sphenopalatine Ganglion Is Targeted?

Sphenopalatine Ganglion is located in a bone cavity in the mid face known as the pterygopalatine fossa. A mass of sensory and motor nerves pass through it connecting the brain with lacrimal gland, nasal cavity, pharynx, palate, sinus, mouth, and various parts of the face, neck, and head.

As a plexus for extensive nerve fibres, the ganglion plays a part in transmitting pain signals originating from face, neck, mouth, nose, and other body parts surrounding it. Blocking the nerve bundle helps inhibit pain signals and divert the attention of the brain toward non-painful sensory signals.

When Patients Require Sphenopalatine Ganglion Block? What Conditions Are Treated Through Sphenopalatine Ganglion Block?

Sphenopalatine Ganglion is found to be effective for management of pain emanating from

  • acute headaches that start and become worse fast requiring frequent medication
  • cluster headaches because of neurological disorder and manifested through severe aching and pain on either side around the eye
  • trigeminal neuralgia due to neuropathic disorder impacting the fifth cranial nerve and causing extreme facial pain
  • TMJ pain or acute pain linked to dysfunction of temporomandibular joints that connect the lower jaw with skull.
  • complex regional pain syndrome associated with musculoskeletal degeneration
  • pain due to head and neck cancer
  • pain due to shingles attributed to herpes zoster or chickenpox infection
  • Sluder’s Neuralgia, a type of acute spasmodic pain in the nose, neck, shoulders and face traced to innervations in sphenopalatine ganglion.
  • migraine headaches
  • vasomotor rhinitis or frequent inflammation of nasal membrane
  • atypical facial pain syndrome
  • tongue and mouth pain
  • paroxysmal hemicranias that results in headache around the eye
  • post-traumatic headache

How Is Sphenopalatine Ganglion Block Performed?

Sphenopalatine Ganglion block is performed in one of three ways.

  • Transnasal Method

It is the most common and simple way to have a Sphenopalatine Ganglion block. Patient lies down on his back and lidocaine gel is introduced to his nasal cavity. Sniffing of gel anesthetize the area, and it was followed with placing of a “10-cm cotton tipped applicator” dipped in numbing drugs to the nostril. It is inserted parallel to the zygoma until the nasopharynx is touched. The applicator is left in its position for 20 to 30 minutes for absorption of the medication and is withdrawn once the procedure is complete.

  • Transoral Method

Sphenopalatine Ganglion block is also achieved by administering numbing medication through transoral method. A tiny dental needle is placed into the gum line and local anesthetic medication is administered through it.

  • Lateral Method

Also called infrazygomatic method, it is carried on under fluoroscopic guidance and anesthetic medication is inserted into the Sphenopalatine Ganglion through a needle in the cheek. Patients lie down in the supine position, and fluoroscopy is used to identify the pterygopalatine fossa. Intravenous sedation used to numb the cheek skin and a thin needle is inserted into the ganglion. Once the needle position is confirmed, anesthetic is inserted to the nervous plexus through it.

How Long Does It Take?

The Sphenopalatine Ganglion block procedure takes about 30 minutes.

What Conditions Do I Experience After Sphenopalatine Ganglion Block?

If you experience tearing and nasal congestion, the procedure is considered successful. The pain relief will be visible as soon as the block is performed.

Do I Need Rest After Sphenopalatine Ganglion Block?

It is an outpatient procedure without any invasive intervention. Patients can go home or attend their regular work as desired.

How Many Sphenopalatine Ganglion Block Injections Should I Have?

The benefit varies from patient to patient with some getting pain relief for weeks and others for years. If a patient finds it beneficial, he can repeat the procedure depending on medical advice. Many prefer to undergo radiofrequency ablation of the nerve plexus to prevent pain for extended durations.

What Are The Side Effects of Sphenopalatine Ganglion Block?

The procedure is popular for its high-acceptance and low-risk character. Patients may experience bitter mouth taste, temporary lightheadedness, and injection site inflammation for a few hours soon after the block. Lack of sensation on the back of the throat is a common side effect that withers away. Occasional nose bleeding may be there if nasal membrane or passageway is abraded.

How Well Does Sphenopalatine Ganglion Block Work? What Are The Benefits of Sphenopalatine Ganglion Block?

  • A 2005 study reported by the Pain Practice journal claimed the block procedure provided relief to that 86% of patients treated with it for face and head pain.
  • According to the Acta Neurochirurgica journal, Sphenopalatine Ganglion block and RFA together ensured complete relief for 24 months when patients were treated for sphenopalatine neuralgia.
  • In 2006, the Chest journal published a meta-analysis that suggested significant relief offered by the treatment for neck cancer pain, tooth pain, and chronic cluster headache.
  • TheAmerican Headache Society reported a study in 2009 recommending radiofrequency ablation of the ganglion to manage uncontrolled cluster headaches.
  • Two studies published in 1997 (Journal ofNeurosurgery) and 2001 (Journal of Laryngology & Otology) supported Sphenopalatine Ganglion block as the most effective way to manage pain caused by head and neck cancer.

References

Piagkou, M; Demesticha, T; Troupis, T; Vlasis, K; Skandalakis, P; Makri, A; Mazarakis, A; Lappas, D; Piagkos, G; Johnson, EO. “The pterygopalatine ganglion and its role in various pain syndromes: from anatomy to clinical practice.” Pain Pract. 2012;12(5):399-412.

Bayer E., Racz G., Day M., et al: Sphenopalatine ganglion pulsed radiogrequency treatment in 30 patients suffering from chronic face and head pain. Pain Practice 2005; 5:223.

Salar G., Ori C., Iob I., et al: Percutaneous thermocoagulation for sphenopalatine ganglion neuralgia, Acta Neurochir. (Wein) 1987; 84:24.

Narouze S, Kapural L, Casanova J, Mekhail N. Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache. Headache. 2009 Apr;49(4):571-7. Epub 2008 Sep 9.

Sanders M, Zuurmond WW. Efficacy of sphenopalatine ganglion blockade in 66 patients suffering from cluster headache: a 12- to 70-month follow-up evaluation. J Neurosurg. 1997 Dec;87(6):876-80.

Guyatt G., Gutterman D., Bauman M., et al: Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American college of chest physician’s task force. Chest 2006; 129:174-181.

Varghese BT, Koshy RC. Endoscopic transnasal neurolytic sphenopalatine ganglion block for head and neck cancer pain. J Laryngol Otol. 2001 May;115(5):385-7.