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