Evaluation of sphenopalatine ganglion blockade via intra oral route for the management of atypical trigeminal neuralgia

Abstract

BackgroundThe sphenopalatine ganglion (SPG) may be involved in persistent idiopathic facial pain and unilateral headaches. The role of SPG blockade via intra oral route in the management of trigeminal neuralgia (TN) is worthy of study.MethodsIn this retrospective study, patient records included patients with atypical TN (type 2) that persisted in spite of conservative treatment for at least 2 years, and an average pain intensity from the craniofacial region visual analogue scale (VAS) before examination. In group I the patients received carmapazepin 800 mg a day for at least 2 years. In group II 3 ml of local anesthetic agent consisting 2 ml bupivacaine and 1 ml prilocain in addition to 1 ml fentanyl, 0.5 ml betametasone disodium phosphate and 0.5 ml opaque was injected by the intraoral route. In this group, injection procedures were performed under local anesthesia with fluoroscopic guidance. The Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction were used for intergroup analysis. Age and sex differences were evaluated with one-way ANOVA and Fisher’s exact tests, respectively.ResultsSignificant differences were found between pre-op and 3rd day VAS values and also pre-op and 1st month VAS values. No significant differences were found between pre-op and 6th month VAS values.ConclusionThe SPG blockade improves the quality of life of patients and a minimally-invasive procedure to management of TN, when compared to other methods.

CT-Guided Ozone Combined With Sphenopalatine Ganglion Block In The Treatment Of Atypical Facial Pain

“…Conventional conservative treatments such as tricyclic antidepressants or anticonvulsants are often used in clinic, but the curative effect is uncertain. As reported in previous studies,, trigeminal ganglion and its branch block, sphenopalatine ganglion block and stellate ganglion block may have a certain effect on this condition [13][14][15].…”

Sphenopalatine Ganglion Block for the Treatment of Acute Migraine Headache

“…The technique was further developed by Simon Ruskin [ 16 ], and in 1925 he used it to treat trigeminal neuralgia. Since then, the indications for SPG block have expanded to include cluster headache, migraine, trigeminal neuralgia, and many more [ 10 , 17 – 19 ].…”

Immediate and Long-Term Outcomes of Microvascular Decompression for Mixed Trigeminal Neuralgia

“…3,11 Other methods have subsequently been attempted to treat atypical facial pain symptoms in particular with a variety of methods, including sphenopalatine ganglion blockade and ophthalmic branch radiofrequency thermocoagulation. 12,13…”