FAQs on Sphenopalatine Ganglion Block

A useful procedure for treating head and facial pain is the sphenopalatine ganglion block. This procedure is minimally invasive, and it is performed right in the doctor’s own office. The success of the block depends on the skill of the physician.

Which nerves are treated with the sphenopalatine ganglion block?

Also called the pterygopalatine ganglion, or the Meckel’s ganglion, the sphenopalatine ganglion is a bundle of parasympathetic nerves that branch off the maxillary nerve (branch of the trigeminal nerve). These nerves border the palatine bone, sphenoid sinus, and maxillary sinus. The sphenopalatine ganglion supply the nasal membranes, soft palate, upper teeth, sinuses, pharynx, lacrimal glands, and mid-face region.

What medical conditions respond to the sphenopalatine ganglion block?

The sphenopalatine ganglion block is used to treat many painful conditions. These include:

  • Trigeminal neuralgia
  • Sphenopalatine neuralgia
  • Migraine headaches
  • Cluster headaches
  • Atypical face pain
  • Cancer pain of the neck and/or head
  • Paroxysmal hemicrania
  • Sluder’s neuralgia
  • Vasomotor rhinitis
  • Herpes zoster (shingles)
  • Temporomandibular joint (TMJ) syndrome
  • Tongue and/or mouth pain
  • Complex regional pain syndrome (CRPS)
  • Cluster headache

What do I do to prepare for the sphenopalatine ganglion block?

Before the procedure, you will meet with the pain management specialist to discuss your medical conditions, current medications, and concerns. The doctor will go over the procedure and ask you to sign a consent form. Notify the doctor if you have a bleeding disorder, have an active infection, or if you have a bad heart. Because a sedative is given, arrange to have someone drive you home. When you arrive at the medical facility, a nurse will help you change into a gown and place an IV line in your hand to administer necessary fluids and medications. Monitoring devices are attached to your body to assess heart rate, blood pressure, and oxygen level.

How does the pain specialist do the sphenopalatine ganglion block procedure?

The most common approach to the block is the intranasal approach, which involves inserting a catheter through the nose. Other methods include the transoral (through mouth) and the infrazygomatic (through cheek). With the intranasal method, the doctor inserts numbing gel into the nose using a cotton swab. After the area is numb, flexible catheter is threaded through the nostril, and an anesthetic and/or neurolytic agent is instilled onto the targeted nerves. During the block, the doctor may use radiofrequency energy to destroy a portion of the nerve root if the medication works.

What occurs after the sphenopalatine ganglion block?

The block takes around 30-45 minutes to perform. Afterwards, the patient is monitored by a nurse for around 30 minutes. Expect to have soreness of the nostril, a mildly sore throat, and drowsiness. We recommend that you rest for 1-2 days, and gradually return to normal activities.

What are the benefits of this interventional pain procedure?

The sphenopalatine ganglion block is a safe, effective procedure used to treat a variety of medical conditions. Done in the outpatient setting, few side effects to the procedure medications exist, and risks/complications rarely occur.

How effective is the sphenopalatine ganglion block?

In a recent research report, the sphenopalatine ganglion block was used to treat chronic face and head pain. According to results, the efficacy rate was 86%, with other studies showing this block useful for trigeminal neuralgia, cluster headache, teeth pain, and cancer pain.

What complications are associated with the sphenopalatine ganglion block?

The sphenopalatine ganglion block has few complications to consider, but they could occur. While rare, risks include bleeding, nerve damage, infection, and blood vessel injury. The most commonly reported side effect is a bitter taste related to the numbing gel, and soreness of the nose and throat.

Resources

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.

Manahan AP, Malesker MA, Malone PM. Sphenopalatine ganglion block relieves symptoms of trigeminal neuralgia: a case report. Nebr Med J. 1996; 81:306-9

Morelli N, Mancuso M, Felisati G, Lozza P, Maccari A, Cafforio G, Gori S, Murri L, Guidetti D. Does sphenopalatine endoscopic ganglion block have an effect in paroxysmal hemicrania? A case report. Cephalalgia. 2009 May 5.

Olszewska-Ziaber A, Ziaber J, Rysz J. Atypical facial pains–sluder’s neuralgia–local treatment of the sphenopalatine ganglion with phenol–case report. Otolaryngol Pol. 2007; 61:319-21.

Quevedo J, Purgavie K, Platt H, et al.: Complex regional pain syndrome involving the lower extremity. a report on 2 cases of sphenopalatine ganglion block as a treatment option Arch Phys Med Rehabil. 2005; 86:335-337.