FAQ’s on Sphenopalatine Ganglion Block
What is a Sphenopalatine Ganglion Block?
The sphenopalatine ganglion is located in the facial area of a patient, and is housed inside a bone cavity of the skull. This ganglion, or nerve cluster, provides sensation to the surrounding facial tissue and structures and to the majority of a patient’s head. The nerves of the sphenopalatine do not provide motor function in any way, they are purely sensory. For patients who may be experiencing pain in the head or face, or who are suffering from chronic headaches, a sphenopalatine ganglion block can provide symptomatic relief by numbing these sensory nerves.
What will a Sphenopalatine Ganglion Block treat?
Relief for many disorders of the face can be obtained by blocking the sphenopalatine ganglion, provided the facial area where symptoms are present is an area that the ganglion provides sensation to. Some of the more common conditions a sphenopalatine ganglion block can provide relief for include episodic or chronic headaches (primarily cluster headaches), pain resulting from shingles, pain from cancerous sources located in the neck or head, specific cases of RSD, or pain arising from TMJ. With an estimated 90% of Americans being affected by a headaches, and 20% of those needing medical intervention due to severity (U.S. News and World Report, 2014), treatments such as the Sphenopalatine block are becoming much more common.
Sphenopalatine ganglion blocks have been shown to be especially effective in the treatment of cluster headaches, with over two-thirds of the subjects achieving relief in a study (Efficacy of sphenopalatine ganglion blockade in 66 patients suffering from cluster headache, 1997) conducted and published in The Journal of Neurology.
How is a Sphenopalatine Ganglion Block performed?
There are multiple methods of injection that may be used during a sphenopalatine ganglion block, with the most common injections being either the lateral approach or the transnasal approach. Many patients will receive this injection with the trasnasal approach due to the relative ease of the procedure and the minimal discomfort it offers patients.
With a trasnasal sphenopalatine block, patients will be placed flat on their back and asked to extend their neck. Once a patient is lying down, an anesthetic gel will be administered to the nostril where patients will be asked in inhale to ensure the entirety of the nasal cavity receives an anesthetic. After the nostril has been fully numbed, an application device will be gently inserted into it where it will be held against the nasophranyx for approximately 30 minutes.
A recent case study (A novel revision to the classical transnasal topical sphenopalatine ganglion block for the treatment of headache and facial pain, 2013) into the success of a transnasal application device versus a traditional needle based treatment found all participating subjects obtaining relief for their symptomatic pains.
Patients who opt to receive the lateral approach will be receiving an injection through their cheek. The area to be injected will be sterilized and numbed with local anesthetic in preparation for a needle that will be guided into the sphenopalatine ganglion with fluoroscopic imaging. When the physician is positive of the needles placement, a numbing agent will be applied to the ganglion to numb the nerves.
Regardless of which approach is used, the end goal is to numb the sphenopalatine ganglion. The numbing of this nerve cluster will stop the transmission of pain signals from the face to the brain, providing symptomatic relief in a large number of treatments. A study (Intranasal sphenopalatine ganglion block: minimally invasive pharmacotherapy for refractory facial and headache pain, 2006) into the effectiveness of a sphenopalatine ganglion block by the Department of Anesthesiology at the University of Utah found the block to be a very effective means of treatment for facial pain and headaches.
What are the risks of a Sphenopalatine Ganglion Block?
There is very minimal risk associated with this treatment. For patients receiving a lateral approach, there is a small chance of bleeding, infection, or soreness at the site of injection. The largest risk patients faced is that the block will not be able to provide adequate pain relief.