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Review
. 2019 Spring;19(1):32-37.
doi: 10.31486/toj.18.0163.

Sphenopalatine Ganglion Block and Radiofrequency Ablation: Technical Notes and Efficacy

Reda Tolba  1 , Austin L Weiss  1 , Daniel J Denis  2   3
Affiliations
Review

Sphenopalatine Ganglion Block and Radiofrequency Ablation: Technical Notes and Efficacy

Reda Tolba et al. Ochsner J. 2019 Spring.

Abstract

Background: Sphenopalatine ganglion (SPG) blockade or lesioning can offer significant pain relief for cluster headaches (CHs) and a variety of other pain syndromes involving the head and face. Methods: We reviewed the literature on the efficacy of SPG block and radiofrequency ablation (RFA) using PubMed and Google Scholar. Results: The infrazygomatic technique can be used to directly access the SPG for injection of local anesthetic or lesioning using RFA. Important technical points to achieve these procedures are described. SPG blockade efficacy is supported by randomized controlled studies but SPG RFA is not. Conclusion: Targeting the SPG is a promising treatment option for refractory CHs. RFA and neuromodulation have the potential to offer long-term significant pain relief, but more randomized studies are needed to demonstrate their efficacy.

Keywords: Cluster headache; radiofrequency ablation; sphenopalatine ganglion block.

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Figures

Figure 1.
Figure 1.
Lateral fluoroscopic view of the face showing superimposed mandibular rami.
Figure 2.
Figure 2.
Fluoroscopic guidance of superomedial advancement of bent-tipped spinal needle toward pterygopalatine fossa.
Figure 3.
Figure 3.
Anteroposterior view showing needle tip terminating immediately lateral to ipsilateral nasal wall.
Figure 4.
Figure 4.
Contrast material injected with appropriate spread confirming correct placement within the pterygopalatine fossa.
See this image and copyright information in PMC

References

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