Sphenopalatine Ganglion Block via the Transnasal Approach

Indications and Clinical Considerations

Sphenopalatine ganglion block may be used in the treatment of acute migraine headache, acute cluster headache, and a variety of facial neuralgias, including Sluder, Vail, and Gardner syndromes ( Fig. 18.1 ). This technique is also useful in the treatment of status migrainosus and chronic cluster headache. There is anecdotal evidence that sphenopalatine ganglion block may also be useful in the palliation of pain secondary to acute herpes zoster of the trigeminal nerve.

Neurodestructive procedures of the sphenopalatine ganglion with neurolytic agents, radiofrequency lesions, and freezing may be indicated for the palliation of cancer pain and rarely for headache and facial pain syndromes that fail to respond to conservative management. Recent experience with electrical stimulation of the sphenopalatine ganglion has shown promising early results.