Sphenopalatine (Pterygopalatine) Ganglion Rhizotomy

The sphenopalatine ganglion (SPG; also known as the pterygopalatine ganglion) is a collection of nerve cells near the back of the nose that mediates sensation over part of the cheek, upper mouth, and nose, as well as autonomic functions of the face, such as salivation and tear production. The SPG appears to play a role in several headache and facial pain disorders, including the trigeminal autonomic cephalgias (e.g. cluster headache, SUNCT/SUNA, among others), pterygopalatine neuralgia, vidian neuralgia, and chronic migraine.

For patients with one of these pain syndromes who have not found relief with medications, I often recommend an injection or nerve block targeting the SPG. This can often be done with just a nasal spray. If a patient notices a temporary benefit from an SPG block, I may recommend a more permanent procedure called SPG rhizotomy.

I perform SPG rhizotomy using Gamma Knife. There is no incision or anesthesia needed, and patients can return home on the day of the procedure. Gamma Knife has an excellent safety profile when used to target the SPG.

If you live near Denver and suffer from a chronic facial pain disorder, please consider meeting me in consultation to learn about surgical treatment options.