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Sphenopalatine Ganglion Block

Headache & Facial Pain Treatment in Colorado

When you suffer from chronic facial pain or headaches that have not improved with medication or conventional therapy, you may benefit from a sphenopalatine ganglion block. This block is a minimally invasive procedure that offers long-lasting pain relief.

What is the sphenopalatine ganglion?

The sphenopalatine ganglion is a small bundle of nerves that transmit pain signals from the face and head to the brain. The nerve ganglion is found in the pterygopalatine fossa, and it axons project to the nasal mucosa and lacrimal glands. Its location is right below the brain and behind the nasal region.

What conditions are treated using the sphenopalatine ganglion block?

The sphenopalatine ganglion block is a versatile pain management procedure used to treat:

  • Trigeminal neuralgia
  • Chronic atypical face pain
  • Migraine headaches
  • Cluster headaches
  • Sphenopalatine neuralgia
  • Cancer-related head and neck pain
  • Mouth/tongue pain
  • Temporomandibular joint (TMJ) syndrome
  • Paroxysmal hemicrania
  • Sluder’s neuralgia
  • Complex regional pain syndrome
  • Herpes zoster pain

What are the benefits of the sphenopalatine ganglion block?

This block is an effective, safe procedure for treating severe face and head pain. The procedure can be done as an outpatient technique, so you can go home soon afterwards. The procedure is simple, and offers long-term pain relief.

How does the sphenopalatine ganglion block work?

The procedure is either used for diagnostic or therapeutic purposes. The diagnostic block involves testing pain response to the block by injecting the nerves with an anesthetic (bupivacaine or lidocaine). With the therapeutic block, the doctor injects a neurolytic agent (alcohol or phenol) onto the nerves, or uses radiofrequency (RF) energy to ablate/destroy the nerve roots.

How many treatments will I need?

With the diagnostic portion of the procedure, the doctor only injects the sphenopalatine ganglion once or twice to confirm the source of pain. The therapeutic procedure can offer relief for several months, and is usually repeated annually for several treatments.

How is the sphenopalatine ganglion block done?

The three methods of injection include:

  • Intranasal approach– This involves numbing the nostril using lidocaine ointment and a cotton-tip applicator. A catheter is inserted into the nostril, and the 0.5% bupivacaine is instilled onto the nerves. The applicator device with the anesthetic is left in place for 30-45 minutes. Signs of a successful block include nasal congestion and tearing. In addition, you will notice pain relief after 30-60 minutes.
  • Infrazygomatic approach– This involves use of x-ray imaging to guide a procedure needle near the nerves. The physician sterilizes the facial skin, and inserts the needle through the cheek region. After the medication is injected, the needle is removed, and a bandage is applied to the cheek.
  • Transoral approach– This involves inserting the procedure needle through the mouth and upward to position near the nerves. After the medication is inserted, the needle is removed.

What happens after the sphenopalatine ganglion block?

Because a sedative is used, you cannot drive for 24 hours. You will wake in the recovery area, and a nurse monitors your condition for an hour. Expect some soreness of the cheek, nose, and/or mouth, depending on the type of approach used. The pain relief will be immediate due to the quick acting anesthetic. We recommend you take it easy for a couple of days and gradually return to usual duties.

Does the sphenopalatine ganglion block work?

In a study of 30 people with chronic head or face pain, researchers found that the block had an 86% efficacy rate. Radiofrequency energy was used to partially destroy the nerves, which offered pain relief for up to 24 months after the procedure. After a large literature review study, researchers concluded that the block was beneficial for treating cluster headache, toothache, neck cancer pain, and trigeminal neuralgia.