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Evaluation of Sphenopalatine Ganglion Blockade via Intra Oral Route for the Management of Atypical Trigeminal Neuralgia

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Evaluation of Sphenopalatine Ganglion Blockade via Intra Oral Route for the Management of Atypical Trigeminal Neuralgia

Ilker Coven et al. Springerplus.

Abstract

Background: The sphenopalatine ganglion (SPG) may be involved in persistent idiopathic facial pain and unilateral headaches. The role of SPG blockade via intra oral route in the management of trigeminal neuralgia (TN) is worthy of study.

Methods: In this retrospective study, patient records included patients with atypical TN (type 2) that persisted in spite of conservative treatment for at least 2 years, and an average pain intensity from the craniofacial region visual analogue scale (VAS) before examination. In group I the patients received carmapazepin 800 mg a day for at least 2 years. In group II 3 ml of local anesthetic agent consisting 2 ml bupivacaine and 1 ml prilocain in addition to 1 ml fentanyl, 0.5 ml betametasone disodium phosphate and 0.5 ml opaque was injected by the intraoral route. In this group, injection procedures were performed under local anesthesia with fluoroscopic guidance. The Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction were used for intergroup analysis. Age and sex differences were evaluated with one-way ANOVA and Fisher's exact tests, respectively.

Results: Significant differences were found between pre-op and 3rd day VAS values and also pre-op and 1st month VAS values. No significant differences were found between pre-op and 6th month VAS values.

Conclusion: The SPG blockade improves the quality of life of patients and a minimally-invasive procedure to management of TN, when compared to other methods.

Figures

Fig. 1
Fig. 1
Once the tip of the needle reached the SPG under direct visualisation of the guidance, the mixture was injected
Fig. 2
Fig. 2
A-27-gauge dental needle was 60° tilted and inserted from 1 cm anterior and 1 cm medial position from the 3rd molar area. Needle was passed through from palatinum majus and it was forwarded to superior-posterior direction for an average 2 cm distance

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