Table 1 Summary of evidence level and grade of recommendation for SPG block, radiofrequency ablation and neurostimulation
From: Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review
Medical condition | Application/ Medication used in controlled studies | Number of controlled studies | Highest level of evidence | Grade of recommendation |
|---|---|---|---|---|
SPG block | ||||
Cluster headache | Cotton swab/cocaine or lidocaine | 1 | 2b | B |
Second-division trigeminal neuralgia | Lidocaine spray | 1 | 2b | B |
Reducing the needs of analgesics after endoscopic sinus surgery | Needle injection, transnasal and palatal approach/lidocaine,bupivacaine, levobupivacaine, tetracaine | 6 | 1b | B |
Reducing the pain associated with nasal packing removal after nasal operation | Needle injection, infrazygomatic approach/lidocaine | 1 | 3b | B |
Migraine | Tx360 device/ bupivicane | 1 | 2b | B |
Postdural puncture headache, sphenopalatine maxillary neuralgia, facial neuralgia, sympathetic neuralgia, post-traumatic atypical facial pain, atypical odontalgia, pain from midline granuloma, herpetic keratitis, hemifacial headache,paroxysmal hemicrania, nasal pain, hemicrania continua, trigeminal neuropathy, cancer pain, seizures associated nasal pathology, arthritic pain and muscle spasm, intercostal neuritis, persistent hiccups, ureteral colic, dysmenorrhea, peripheral painful vascular spasm, complex regional pain syndrome and hypertension | Various protocols | 0 | 4 | C |
Myofascial pain | Cotton-tipped applicator, nasal spray/lidocaine | 2 | 2b | Not recommended |
SPG radiofrequency ablation | ||||
Cluster headache | Infrazygomatic approach/80 °C, 60s ×2 | 0 (1 cohort study) | 2b | B |
Sluder’s neuralgia, posttraumatic headache, chronic head and face pain, atypical trigeminal neuralgia, atypical facial pain, chronic facial pain secondary to cavernous sinus meningioma, trigeminal neuralgia, SPG neuralgia due to herpes zoster | Various protocols | 0 | 4 | C |
SPG neurostimulation | ||||
Cluster headache | Customized to each patient, mean frequency 120.4 ± 15.5 Hz, pulse width 389.7 ± 75.4 μs, intensity 1.6 ± 0.8 mA | 1 | 1b | B |
Idiopathic facial pain, migraine | Various protocols | 0 | 4 | C |