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Neuroradiology

, Volume 56, Issue 7, pp 589–596 | Cite as

Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain

  • Adrian KastlerEmail author
  • Gilles Cadel
  • Alexandre Comte
  • Guillaume Gory
  • Veronique Piccand
  • Laurent Tavernier
  • Bruno Kastler
Head and Neck Radiology

Abstract

Introduction

The sphenopalatine ganglion (SPN) has been proven to be involved in various types of facial pain syndromes. Management of these cranio-facial pain syndromes can be challenging, and existing specific treatments are sometimes inefficient and may fail. The purpose of this study is to describe and evaluate alcohol SPN in the management of cranio-facial pain.

Methods

Forty-two patients suffering from refractory facial pain who underwent 58 consecutive SPN were included in this study between 2000 and 2013. Patients were divided into three groups: group “cluster headache” (CH), group “persistent idiopathic facial pain” (PFIP), and group “Other”. Pain was assessed using Visual Analogue Scale scores (measured immediately before and after procedure and at regular intervals following the procedure). Alcohol SPN was considered to be effective when pain relief was equal to or greater than 50 % and lasting for at least 1 month. All procedures were realized ambulatory under CT guidance and consisted of an injection of 1 ml of absolute alcohol.

Results

Overall efficacy rate of alcohol SPN was 67.2 %, with mean pain relief duration of 10.3 months. Procedure was graded either not painful or tolerable by patients in 64.2 %. Analysis showed a higher efficacy rate in the groups CH (76.5 %) and PFIP (85.7 %) compared to the group Other (40 %). No difference was found between groups regarding the recurrence rate.

Conclusion

Alcohol SPN under CT guidance appears as a safe and effective treatment of refractory facial pain, especially in cases of cluster headache and persistent idiopathic facial pain.

Keywords

Sphenopalatine ganglion Cranio-facial pain Alcohol Neurolysis CT guidance 

Notes

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the local institutional review board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Adrian Kastler
    • 1
    • 2
    Email author
  • Gilles Cadel
    • 2
  • Alexandre Comte
    • 3
  • Guillaume Gory
    • 2
  • Veronique Piccand
    • 4
  • Laurent Tavernier
    • 2
    • 5
  • Bruno Kastler
    • 2
    • 6
  1. 1.Neuroradiology DepartmentGrenoble University HospitalGrenobleFrance
  2. 2.I4S Laboratory, EA4268, IFR133Franche Comté UniversityBesançonFrance
  3. 3.Functional Imaging Research DepartmentUniversity Hospital BesançonBesançonFrance
  4. 4.Pain Evaluation and Treatment UnitUniversity Hospital Jean MinjozBesançonFrance
  5. 5.Head and Neck Surgery–Otolaryngology UnitUniversity Hospital Jean MinjozBesançonFrance
  6. 6.Interventional Pain Management UnitUniversity Hospital Jean MinjozBesançonFrance

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