Table 13.
Studies of SPG radiofrequency ablation on cluster headache
| Cluster headache | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| First author | Year | Medical problem | Approach | Imaging | Temperature (°C) | Type of RFA | Parameter | How to identify right spot | Study design | Number of cases | Outcome |
| Sanders et al. [39] | 1997 | Cluster headache | Infrazygomatic approach | Fluoroscopy | 70 | High frequency | 50 Hz, 0.2-1 V | Paresthesia in the palate | Case-only | 66 | 60.7% of episodic cluster headache patients received complete relief, 30% in chronic cluster headache patients achieved complete relief |
| Narouze et al. [38] | 2009 | Chronic cluster headache | Infrazygomatic approach | Fluoroscopy | 80 | Unknown | 50 Hz at <0.5 V to produce deep paresthesia behind the root of the nose | . | Prospective cohort | 15 | Mean attack intensity, mean attack frequency, pain disability index significant reduced at 1 year follow-up (P < 0.0005, P < 0.0003, P < 0.002, respectively) |
| Chua et al. [78] | 2011 | Cluster headaches | Infrazygomatic approach | Fluoroscopy | 42 | Pulsed | 50 Hz, 0.5-0.7 V | Paresthesia at the root of the nose | Case series | 3 | Two had excellent relief, one had partial relief by 2 months |
| Oomen et al. [79] | 2012 | Atypical facial pain, cluster headache, Sluder’s neuralgia, Sluder’s neuropathy | Infrazygomatic approach | Fluoroscopy | 80 | Unknown | 50 Hz | Paresthesia in the nose and not in the area of the maxillary nerve | Case series | 3 | Adequate pain reduction: 4/4 in atypical facial pain, 2/3 in cluster headache, 1/2 in Sluder’s neuralgia, 2/2 in Sluder’s neuropathy, 1/1 in posttraumatic neuropathy, 0/1 in post-herpetic neuralgia, 0/1 in SUNCT (60% showed considerable pain relief after a single procedure). |
| Zarembinski et al. [54] | 2014 | Drug-resistant chronic cluster headache, with Jacob’s disease | Initially sphenopalatine ganglion block, then radiofrequency. | Fluoroscopy, CT | Unknown | Unknown | Unknown | NA | Case report | 1 | Pain significantly improved. |
| Fang et al. [80] | 2015 | Cluster headache | Infrazygomatic approach | CT | 42 | Pulsed | Unknown | 0.1-0.3 V to induce paresthesia of the nasal root | Case series | 16 | 11 episodic and 1 chronic cluster headache patients had complete relief by 6.3 days. 2 episodic and 2 chronic cluster headache patients had no relief. |
| Bendersky et al. [81] | 2015 | Cluster headache | Infrazygomatic approach | Fluoroscopy | 42 | Pulsed | 45 V, 2 Hz, pulse width 20 ms | Paresthesia at the roof of the nose | Case series | 3 | 2 patients had no relief, 1 had relief until 1 month. Continue RFA gave relief to all three patients. |
| Dharmavaram et al. [82] | 2016 | Cluster headache | Lateral approach | Fluoroscopy | 80 | Continuous | Unknown | paresthesia at the root of the nose was obtained at 0.3 V | Case report | 1 | Pain free for 2 months |
| Loomba et al. [83] | 2016 | Cluster headache | Infrazygomatic approach | CT | 80 | Continuous | 50 Hz | <0.3 V to induce paresthesia of the nasal root | Case report | 1 | Near complete resolution at 6 months |