Sphenopalatine Ganglion Blocks for Trigeminal Neuralgia and RSD

What is a sphenopalatine ganglion?

facial pain2The sphenopalatine ganglion is a 5mm in size bundle collection of sympathetic, parasympathetic and sensory nerves that lie in the pterygopalatine fossa, a triangularly shaped cavity found deep in the mid-face, anterior to the pterygoid canal and behind the area called the middle nasal turbinate.

This ganglion is covered by connective tissues and membrane, and it supplies with nerve fibers the paranasal sinuses, the lacrimal gland, glands of the hard palate, the mucous membrane and upper pharynx. These nerves have no control over the movement of the face muscles.

When is a sphenopalatine ganglion block performed?

In case of injury, trauma or infection, nerves can become more sensitive and the sympathetic activity can cause discomfort associated with pain symptoms. Doctors will perform a sphenopalatine ganglion block either to detect or relief the pain by interrupting the nerve signals.

Some of the most common conditions that require blocking the ganglion are: acute or cluster headaches, atypical facial pain, complex regional pain syndrome, trigeminal neuralgia, herpes zoster, reflex sympathetic dystrophy, paroxysmal hemicrania or even cancer (head or neck).

What happens during the procedure?

Sphenopalatine Ganglion BlockDue to the ganglion’s position, doctors may choose to perform a topical nerve block or injected nerve block via the nose (trans-nasal – simplest and most common), the mouth (trans-oral) or via the lateral route.

In case of a trans-nasal procedure, the patient will be asked to lie on their back, extending their neck with face in the air. Right after, the physician will visually inspect the insides of your nose, for visible tumors, polyps, or any deviations of the septum. A small amount of viscous lidocaine (2%) is placed into the nose and the patient will be asked to inhale, this way the local anesthetic will reach the posterior nasal pharynx, increasing the lubrification of the area and numbing it in the same time, thus making the patient more comfortable and ready for the injection.

If a topical block is preferred, then the physician will introduce a sterile 10cm applicator with a cotton tip that has been dipped in anesthetic and will slowly advance it into the nose, pushing the applicator along the superior border of the middle turbinate until it has reached the posterior wall of the nasopharynx. The applicator will remain in place for about 20 to 30 minutes so that the ganglion can absorb the medication.

When the Chicago pain management physician anesthetizes part of your cheek, it means he or she chose to perform the sphenopalatine ganglion block via injection. The tissue will be numbed, and guided by fluoroscopy, a small needle will be inserted in through the face and straight into the ganglion’s area, and the nerve block will be released.

If the procedure is successful, the patient will feel an immediate decrease in the amount of pain. Know that this type of treatment only offers a temporary solution to the problem. If the block goes well, then patients can consider neurolysis or a radio ablation of the sphenopalatine ganglion for better, long term results.

Overall, the sphenopalatine ganglion block is a brief and minimally invasive procedure that proves to be successful in treating facial and head pain.

Premier Pain & Spine offers the SPG block as a top Chicago pain center. Call (847) 519-4701 for scheduling.




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