Sphenopalatine ganglion block in orofacial pain and headache disorders: A review of case reports

OBJECTIVE: To review and synthesize published case reports on the use of sphenopalatine ganglion (SPG) block in orofacial and headache disorders, focusing on techniques and clinical outcomes. METHODS: A review of 55 case reports and series extracted data on 29 papers, including diagnoses, SPG block technique, anesthetic or drug, outcomes, and adverse effects. RESULTS: SPG block was reported in trigeminal neuralgia and neuropathies, burning mouth syndrome, non-specified facial pain, autonomic cephalalgias, migraine, tension type headache, COVID related headache and acute cephalalgias. The most frequently used technique was intranasal with cotton tip applicators, with lidocaine 2-10% as the most common agent. Most reports document relief, but long-term data is not available. Neurogenic pain conditions and migraine showed superior therapeutic responses to the SPG block procedure. CONCLUSION: SPG block appears effective and safe, though higher-level evidence is still needed.