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Transnasal Versus Suprazygomatic SPG Block in Persistant Idiopathic Facial Pain

Completed
Conditions
Headache
Persistent Idiopathic Facial Pain
Interventions
Drug: Transnasal Sphenopalatine ganglion block
Drug: Ultrasound-guided suprazygomatic sphenopalatine ganglion block
Registration Number
NCT06496841
Lead Sponsor
Diskapi Teaching and Research Hospital
Brief Summary

The International Headache Society defines persistent idiopathic facial pain (PIFP) as persistent facial pain that does not have the characteristics of cranial neuralgia, is blunt, persistent, persistent, bothersome and not attributable to another disorder. The management of persistent idiopathic facial pain (PIFP) is complex. The sphenopalatine ganglion (SPG) has been the target of interventional treatment of many facial pain syndromes. The sphenopalatine ganglion can be accessed by transnasal access and ultrasound or scopy guidance. In this study, datas compared the efficacy of transnasal approach and ultrasound-guided suprazigomatic approach in sphenopalatine ganglion block in patients with persistent idiopathic facial pain.

Detailed Description

Patients with chronic head and facial pain are frequently referred to us and some of these patients are persistent idiopathic facial pain patients who do not respond to conservative treatment. Various interventional treatment modalities can be applied to these patients. One of the treatments we frequently apply is sphenopalatine ganglion (SPG) blockage, which has an important place in the pathogenesis of chronic headache. The SPG is the target area for the treatment of cluster headache, migraine, postherpetic neuralgia, trigeminal neuralgia and other atypical facial pain syndromes due to its anatomical localisation and its role in the trigemino-cervical reflex. Although there are various techniques for SPG block, the simplest and most easily applicable is the transnasal approach and the traditional method is to apply a block with a cotton-tipped swab. Various local anaesthetics can be used, the most commonly used local anaesthetic is 2-3 ml of 2% or 10% lidocaine, usually administered through one nostril for 30 minutes. It is also possible to access SPG via the suprazygomatic route, and studies have shown that SPG block applied via the suprazygomatic route provides effective treatment of chronic headaches. In ultrasound-guided SPG block, after visualising the pterygopalatine fossa with USG, 3-4 mL of 2% lidocaine is administered to the area and blockage is achieved.

Our study was designed retrospectively. The primary aim of the study was to compare the efficacy of transnasal and suprazigomatic routes based on Numerical Rating Scale (NRS) pain scores by reviewing the files of patients who underwent sphenopalatine ganglion block for persistent idiopathic facial pain. The pain scores recorded before the procedure and one and four weeks after the procedure will be compared.

In this study, primary aim is to evaluate the efficacy of these two treatment modalities, with retrospectively evaluate the Visual Analogue Scale (VAS) score, HIT-6 (Headache Impact Test-6) score and headache diary data of the patients who have previously undergone these treatments in the pain clinic.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Diagnosis of persistent idiopathic facial pain according to ICHD-3 beta criteria
  • Moderate to severe pain (pain of 6 or more on a numeric pain scale of 0-10)
  • Persistence of pain for more than 6 months
  • Pain unresponsive to conservative methods
Exclusion Criteria
  • Presence of secondary headache (tumor, bleeding, stroke, etc.)
  • Cognitive impairment
  • Hepatic or renal insufficiency
  • Local or systemic infection
  • Coagulopathy
  • Patient refusal to accept treatment

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Transnasal sphenopalatine ganglion block groupTransnasal Sphenopalatine ganglion blocktransnasal administration of lidocaine to the sphenopalatine ganglion
Ultrasound-guided suprazygomatic sphenopalatine ganglion block groupUltrasound-guided suprazygomatic sphenopalatine ganglion blockultrasound-guided suprazygomatic approach
Primary Outcome Measures
NameTimeMethod
Numerical Rating Scale (NRS)Change from baseline to 1st hour, 1st week and 4th weeks after treatment

NRS is a pain screening Scale, in time using a 0-10 Scale, with zero meaning ''no pain'' and 10 meaning ''the worst pain imaginable''.

Secondary Outcome Measures
NameTimeMethod
HIT-6 (Headache impact test)Change from baseline to 1st hour, 1st week and 4th weeks after treatment

HIT-6 is a self-report questionnare designed to evaluate the impact of headache on quality of life. 49 or less: little or no impact, 50-55: some impact, 56-59. substantial impact, 60-78: severe impact

Trial Locations

Locations (1)

Ankara Etlik City Hospital

🇹🇷

Ankara, Yenimahalle, Turkey

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