Interventional pain medicine · 2025
Thermal radiofrequency of the sphenopalatine ganglion in persistent idiopathic facial pain using a suprazygomatic approach: Case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Lasso Andrade Fabricio Andres, Gaviria Suarez Gabriel, Fernández Escobar Alejandro, Rivera Díaz Roberto Carlo, Achicanoy Puchana Denny Marcela, Toro-López Javier Esteban
Аннотация
INTRODUCTION: The sphenopalatine ganglion (SPG) is a key structure in the pathophysiology of various craniofacial pain syndromes with autonomic manifestations, integrating parasympathetic, sympathetic, and trigeminal fibers within the trigemino-autonomic reflex. Modulation of these pathways through nerve block or radiofrequency has shown effectiveness in managing pain and associated autonomic symptoms. However, no previous reports have described the use of a suprazygomatic approach for thermal radiofrequency of the SPG.
CASE REPORT: We present the case of a 70-year-old man with a one-year history of left-sided persistent idiopathic facial pain (PFPS), characterized by paroxysmal exacerbations in the V1-V2 territories, epiphora, and nasal congestion, without evidence of structural lesions or classical neuropathy. After unsuccessful treatment with carbamazepine and a diagnostic Gasserian ganglion block, a suprazygomatic SPG block with 1 % lidocaine was performed, achieving 80 % pain relief lasting four weeks. Upon recurrence of pain, fluoroscopy-guided thermal radiofrequency (TRF) of the SPG (80 °C, 60 s) was conducted, resulting in sustained improvement (NRS 1/10) at six months, with no sensory deficits or adverse effects. This case demonstrated that the suprazygomatic approach provides a safe route to access the pterygopalatine fossa.
CONCLUSION: Thermal radiofrequency of the SPG via the suprazygomatic approach may represent an effective and safe alternative for treating persistent idiopathic facial pain with autonomic features.
CASE REPORT: We present the case of a 70-year-old man with a one-year history of left-sided persistent idiopathic facial pain (PFPS), characterized by paroxysmal exacerbations in the V1-V2 territories, epiphora, and nasal congestion, without evidence of structural lesions or classical neuropathy. After unsuccessful treatment with carbamazepine and a diagnostic Gasserian ganglion block, a suprazygomatic SPG block with 1 % lidocaine was performed, achieving 80 % pain relief lasting four weeks. Upon recurrence of pain, fluoroscopy-guided thermal radiofrequency (TRF) of the SPG (80 °C, 60 s) was conducted, resulting in sustained improvement (NRS 1/10) at six months, with no sensory deficits or adverse effects. This case demonstrated that the suprazygomatic approach provides a safe route to access the pterygopalatine fossa.
CONCLUSION: Thermal radiofrequency of the SPG via the suprazygomatic approach may represent an effective and safe alternative for treating persistent idiopathic facial pain with autonomic features.