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Table 11 Studies of SPG blocks for other pain syndromes of the head and face

From: Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review

Pain syndromes of the head and face
Author Year Medical problems Approach Imaging Medication Number of cases Study design Outcome
Ruskin et al. [62] 1925 SP maxillary neuralgia, SP facial neuralgia, SP sympathetic neuralgia, SPG cell neuralgia Needle injection. None 20% Cocaine, 10% silver nitrate, 70% alcohol 7 Case series Improvements or complete relief
Stechison et al. [63] 1994 Post-traumatic atypical facial pain syndrome Needle injection. Transfacial transpterygomaxillary access to foramen rotundum SPG and maxillary nerve CT First stage: 0.5% bupivacaine, Second stage: 98% ethyl alcohol and 0.5% bupivacaine in 2:1 ratio 5 Case series 3 had alcohol neurotomy and pain free at 5, 8 and 12 months. 2 responded poorly to first stage blockade and did not have alcohol neurotomy.
Peterson et al. [12] 1995 Atypical odontalgia Cotton tip, self-application None 4% lidocaine 1 Case report Pain free
Saade et al. [64] 1996 Pain from midline granuloma Self-administered SPG block None Lidocaine 1 Case report Significant pain relief
Puig et al. [65] 1998 Sluder’s neuralgia Cotton tip applicator and transnasal needle None 88% phenol 8 Case series 90% decrease in head and face pain for 9.5-month duration
Windsor et al. [66] 2004 Herpetic keratitis Transnasal cotton tip applicator None Tetracaine, adrenalin and 10% cocaine] 1 Case report Effect of block lasts for a month. Requires months blocks
Obah et al. [67] 2006 Hemifacial and headache Transnasal None 4% lidocaine 1 Case report 80% reduction in pain intensity
Cohen et al. [33] 2009 Postdural puncture headache Cotton tip applicator None Lignocaine 13 Case series 11 out of 13 had immediate relief of headache
Morelli et al. [68] 2010 Paroxysmal hemicrania resistant to multiple therapies Endoscopic needle injection into the nasal mucous membrane immediately behind and over the inferior portion of the sphenopalatine foramen and into the fossa None Triamcinolone acetonide, 1% bupivacaine, 2% mepivacaine with adrenalin 1 Case report Reduction in frequency and intensity of pain
Rodman et al. [35] 2012 Nasal pain or headache Endoscopic needle injection None 0.5% bupivacaine and triamcinolone acetonide 147 Case series 81.3% of patients have improvement
Grant et al. [69] 2014 Tension headache in pregnant woman Cotton tip applicator None 4% lidocaine 1 Case report BID block for a total of 7 blocks, pain free after
Kastler et al. [55] 2014 Cluster headache (14), persistent idiopathic facial pain (10), and other types of facial pain (18) Infrazygomatic approach CT Absolute alcohol 28 Case series 85.7% of patient with persistent idiopathic facial pain and 40% of other types of facial pain had 50% pain relief at 1 month
Androulakis et al. [70] 2016 Hemicrania continua Tx360 device None Repetitive 0.5% bupivacaine 1 Case report Significant improvement in headache by 14 week
Malec-Milewska et al. [71] 2015 Trigeminal neuropathy Zygomatic approach Fluoroscopy 65% ethanol with lidocaine 20 Case series Significant pain relief
Schaffer [34] 2015 Acute anterior or global headache Tx360 device None 0.5% bupivacaine 93 Randomized placebo-controlled No statistically significant difference
Sussman et al. [72] 2016 Chronic posttraumatic headache after sport-related concussion Cotton-tip applicator None 2% lidocaine and 0.5% bupivacaine 1 Case report Symptom free at 6-month follow-up