The Sphenopalatine Ganglion Radiofrequency Thermocoagulation on a Patient of CRPS with Facial Pain and Pruritus -A report of 2 cases-

2006 ◽  
Vol 19 (2) ◽  
pp. 228 ◽  
Author(s):  
Seung Jae Park ◽  
Dong Eon Moon ◽  
Won Young Kim ◽  
Jung Ju Park ◽  
Eun Jeong Cho ◽  
...  
Keyword(s):  
Facial Pain ◽  
Sphenopalatine Ganglion ◽  
Radiofrequency Thermocoagulation

scholarly journals Radiofrequency Thermocoagulation Through Foramen Rotundum Versus Foramen Ovale for the Treatment of V2 Trigeminal Neuralgia

2019 ◽  
Vol 6 (22;6) ◽  
pp. E609-E614
Author(s):  
Cong-yang Yan
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Operation Time ◽  
Controlled Clinical Trial ◽  
Gasserian Ganglion ◽  
Internal Opening ◽  
Foramen Ovale ◽  
Maxillary Nerve ◽  
Radiofrequency Thermocoagulation ◽  
Foramen Rotundum

Background: Percutaneous radiofrequency thermocoagulation through the foramen rotundum (FR) is a new approach for the treatment of V2 trigeminal neuralgia (TN). Objectives: This study aimed to compare the efficacy and safety of the FR approach with that of the foramen ovale (FO) approach. Study Design: Nonrandomized controlled clinical trial. Setting: The study was conducted at Huaian Hospital of Huaian City, Huaian, China. Methods: From July 2014 to December 2016, 80 consecutive patients with V2 TN were prospectively assigned into the FO group (n = 40) or the FR group (n = 40). All radiofrequency thermocoagulation procedures were performed under the guidance of digital subtraction angiography (DSA). Patients in the FO group were treated with Gasserian ganglion ablation through the Hartel approach. Patients in the FR group received ablation of the maxillary nerve at the internal opening of the FR. Facial pain was evaluated using the Visual Analog Scale preoperatively and postoperatively at 1 week, 6 months, and 1 year. Results: All surgical procedures were successfully completed using DSA guidance. The FR group had no facial pain at postoperative 1 week, 6 months, and 1 year. The facial fain was not relieved in 4 patients of the FO group. They were treated with radiofrequency thermocoagulation of the maxillary nerve through the FR and maintained painless at postoperative 1 week, 6 months, and 1 year. At postoperative 1 year, another 3 patients relapsed in the FO group. The incidences of facial numbness and swelling did not differ significantly between the 2 groups (all P > 0.05). There was no postoperative corneal involvement or masticatory weakness in the FR group. However, corneal involvement and masticatory weakness occurred postoperatively in 22 (55%) patients and 31 (77.5%) patients in the FO group. The FR group had significantly shorter operation time than the FO group (19.3 ± 5.9 vs. 32.7 ± 8.7 minutes; P < 0.05). Limitations: We were unable to avoid the V1 and V3 branches, despite multiple adjustments of the needed position in 35 of the 40 patients in this group. Conclusions: For the treatment of V2 TN, thermocoagulation of the maxillary nerve through the FR had better efficacy and fewer complications in comparison with the Gasserian ganglion ablation through the FO

Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain

2014 ◽  
Vol 56 (7) ◽  
pp. 589-596 ◽  
Author(s):  
Adrian Kastler ◽  
Gilles Cadel ◽  
Alexandre Comte ◽  
Guillaume Gory ◽  
Veronique Piccand ◽  
...  
Keyword(s):  
Facial Pain ◽  
Sphenopalatine Ganglion

scholarly journals Sphenopalatine Ganglion Electrical Nerve Stimulation Implant for Intractable Facial Pain

2015 ◽  
Vol 3;18 (3;5) ◽  
pp. E403-E409
Author(s):  
Foad Elahi
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Local Anesthetic ◽  
Nerve Stimulation ◽  
Facial Pain ◽  
Pain Clinic ◽  
Sphenopalatine Ganglion ◽  
Electrical Nerve Stimulation ◽  
Persistent Idiopathic Facial Pain ◽  
Electrical Neuromodulation

Persistent idiopathic facial pain can be extremely difficult and significantly challenging to manage for the patient and the clinician. Pharmacological treatment of these painful conditions is not always successful. It has been suggested that the autonomic reflex plays an important role in the pathophysiology of headaches and facial neuralgia. The key structure in the expression of cranial autonomic symptoms is the sphenopalatine ganglion (SPG), also known as the pterygopalatine ganglion. The role of the SPG in the pathophysiology of headaches and facial pain has become clearer in the past decade. In this case report, we describe a 30-year-old woman with insidious onset of right facial pain. She was suffering from daily pain for more than 9 years prior to her visit at the pain clinic. Her pain was constant with episodic aggravation without a predisposing trigger factor. The patient was evaluated by multiple specialties and tried multimodal therapy, which included antiepileptic medications, with minimal pain relief. A SPG block using short-acting local anesthetic provided significant temporary pain relief. The second and third attempt of SPG block using different local anesthetic medications demonstrated the same responses. After a thorough psychological assessment and ruling out the presence of a correctable cause for the pain, we decided to proceed with SPG electrical neuromodulation. The patient reported significant pain relief during the electrical nerve stimulation trial. The patient underwent a permanent implant of the neurostimulation electrode in the SPG region. The patient was successfully taken off opioid medication and her pain was dramatically responsive during a 6-month follow-up visit. In this article we describe the SPG nerve stimulation and the technical aspect of pterygopalatine fossa electrode placement. The pterygoplatine fossa is an easily accessible location. This case report will be encouraging for physicians treating intractable facial pain by demonstrating a novel therapeutic option. This report shows a minimally invasive approach to the SPG. Key words: Sphenopalatine ganglion, persistent idiopathic facial pain, electrical neuromodulation

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