Why Sphenopalatine Ganglion Block/ Radiofrequency Treatment is done?

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Sphenopalatine Ganglion block and radiofrequency treatment is done for the following painful conditions –

• Cluster headache

• Sphenopalatine neuralgia

• Trigeminal neuralgia (a few selected cases)

• A few selected cases of migraine.

• Atypical facial pain

• Herpes zoster ophthalmicus.

• Cancer pain.

Sphenopalatine ganglion involvement in the pathogenesis of pain  was first described by Sluder in 1908 and treated with Sphenopalatine ganglion block. Largest group of neurones outside the cranial cavity.

 

What are the symptoms of Sphenopalatine Neuralgia?

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Sphenopalatine neuralgia symptoms are usually unilateral facial pain at root of nose spreading to zygoma/ mastoid/ occiput associated with lacrimation and/or rhinorrhea.

 

Is Sphenopalatine Ganglion block / Radiofrequency treatment painful?

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Sphenopalatine Ganglion block / Radiofrequency treatment is usually done under local anaesthesia, in some cases sedation with propofol or fentanyl is used. So patient usually do not experience pain during procedure.

 

How does Sphenopalatine ganglion RF treatment helps in Cluster Headache?

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The rationale behind the Radiofrequency treatment of the Sphenopalatine ganglion in cluster headache is influenced by the parasympathetic symptoms during the attack and by vasoactive substances like calcitonin gene-related peptide.

 

What is the chance of success after Sphenopalatine ganglion radiofrequency in episodic cluster headache?

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According to the retrospective study by Sanders and his colleagues on refractory cluster headache treated by Sphenopalatine ganglion radiofrequency, 60.7% patients with episodic cluster headache had complete pain relief.

They have taken 56 patients with episodic and 10 patients with chronic cluster headache for the study and the patients were followed up for 12 to 70 months.

 

What are the possible complications of the Sphenopalatine ganglion radiofrequency procedure?

 

• Dryness of the eyes.

• Hypesthesia of the palate. It generally disappears after 6 to 8 weeks.

• Nose bleeding and swelling of cheek as a result of hematoma.

• Accidental lesion of the maxillary nerve.

 

 

 

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;87:876–880.