Sphenopalatine Ganglion Blockade

The primary nerve that mediates headaches is the trigeminal nerve. The sphenopalatine ganglion is a group of nerve cells located behind the nose and connected to the trigeminal nerve. The sphenopalatine ganglion carries a lot of sensory information, including pain, so blocking the sphenopalatine ganglion has been found to provide relief from primary headaches by modulating autonomic fibers involved in headache disorders. Sphenopalatine ganglion blocks have provided significant improvement in those with acute and chronic facial and headaches, especially those suffering from chronic cluster and migraine headaches.

A transnasal (through the nose) or lateral approach can be used to perform a sphenopalatine ganglion block. If the procedure is performed transnasally, an anesthesia-soaked applicator is inserted into the nose until the correct placement is reached and then left in place for 20-30 minutes. If the sphenopalatine ganglion block is performed by lateral injection, the cheek is numbed and a small needle is guided through the tissue using X-ray guidance. After the needle is inserted, the anesthetic is injected.

Radiofrequency can also be used to perform nerve blocks. This is based on the principle that a probe tip generates heat between 40 and 80 °C with radio waves to produce an analgesic effect (pain relief). This causes the targeted nerve to be destroyed and the pain to stop.