What is the sphenopalatine ganglion?
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 sphenopalatine neuralgia, trigeminal autonomic cephalgias (e.g. cluster headache, SUNCT/SUNA, among others), and chronic migraine.
What are the treatment options?
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 is done with just a nasal spray, typically by an ENT or interventional pain doctor. If a patient notices a temporary benefit from an SPG block, I may recommend a more permanent procedure called SPG rhizotomy.
How is SPG rhizotomy performed?
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. Please click here to review my Gamma Knife guide for patients.
Should I meet with you?
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.