Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain
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 descr...
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| Veröffentlicht in: | Neuroradiology 2014-07, Vol.56 (7), p.589-596 |
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| creator | Kastler, Adrian Cadel, Gilles Comte, Alexandre Gory, Guillaume Piccand, Veronique Tavernier, Laurent Kastler, Bruno |
| description | 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. |
| doi_str_mv | 10.1007/s00234-014-1354-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1554949562</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3383414261</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-c1f61c7955d2723149f3d58729e70e05bbd37893545db80a976d4217c706c5d33</originalsourceid><addsrcrecordid>eNqNkU1v1DAYhC0EotuWH8AFReLSi-H1V2wfqwpKpUpc6NnyOs6uq8RO7eSQf4-3KQghIXHyYZ6ZV-NB6D2BTwRAfi4AlHEMhGPCBMfrK7QjnFFMNIXXaFdlhZnmcIbOS3kEACaZfIvOKJcSdAs79HQ9uHRMQzP57JbZRp-W0kS_5DSsJZQm9c189E2Zjj6myQ52DtE3BxsPQ0ixCfFZHm20Bz_6OJ8M2ffZujnltXHZxpBwb12w9YgN8RK96e1Q_LuX9wI9fP3y4-Ybvv9-e3dzfY8dZ2rGjvQtcVIL0VFJGeG6Z51QkmovwYPY7zsmla61RbdXYLVsO06JdBJaJzrGLtDVljvl9LT4MpsxFOeHYetoiBBccy1a-h8oVy1TSsmKfvwLfUxLjrXIM0XaVjBRKbJRLqdS6neYKYfR5tUQMKfpzDadqdOZ03RmrZ4PL8nLfvTdb8evrSpAN6BUKR58_uP0P1N_Ao15pD0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1548166535</pqid></control><display><type>article</type><title>Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Kastler, Adrian ; Cadel, Gilles ; Comte, Alexandre ; Gory, Guillaume ; Piccand, Veronique ; Tavernier, Laurent ; Kastler, Bruno</creator><creatorcontrib>Kastler, Adrian ; Cadel, Gilles ; Comte, Alexandre ; Gory, Guillaume ; Piccand, Veronique ; Tavernier, Laurent ; Kastler, Bruno</creatorcontrib><description>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.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-014-1354-y</identifier><identifier>PMID: 24770960</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Alcohol ; Chronic Pain - diagnostic imaging ; Chronic Pain - therapy ; Disease management ; Ethanol - therapeutic use ; Face ; Facial Pain - diagnostic imaging ; Facial Pain - therapy ; Female ; Head and Neck Radiology ; Humans ; Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nerve Block - methods ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Pain management ; Radiography, Interventional - methods ; Radiology ; Sphenopalatine Ganglion Block - methods ; Tomography, X-Ray Computed - methods ; Treatment Outcome</subject><ispartof>Neuroradiology, 2014-07, Vol.56 (7), p.589-596</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-c1f61c7955d2723149f3d58729e70e05bbd37893545db80a976d4217c706c5d33</citedby><cites>FETCH-LOGICAL-c438t-c1f61c7955d2723149f3d58729e70e05bbd37893545db80a976d4217c706c5d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00234-014-1354-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-014-1354-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24770960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kastler, Adrian</creatorcontrib><creatorcontrib>Cadel, Gilles</creatorcontrib><creatorcontrib>Comte, Alexandre</creatorcontrib><creatorcontrib>Gory, Guillaume</creatorcontrib><creatorcontrib>Piccand, Veronique</creatorcontrib><creatorcontrib>Tavernier, Laurent</creatorcontrib><creatorcontrib>Kastler, Bruno</creatorcontrib><title>Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alcohol</subject><subject>Chronic Pain - diagnostic imaging</subject><subject>Chronic Pain - therapy</subject><subject>Disease management</subject><subject>Ethanol - therapeutic use</subject><subject>Face</subject><subject>Facial Pain - diagnostic imaging</subject><subject>Facial Pain - therapy</subject><subject>Female</subject><subject>Head and Neck Radiology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nerve Block - methods</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Pain management</subject><subject>Radiography, Interventional - methods</subject><subject>Radiology</subject><subject>Sphenopalatine Ganglion Block - methods</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Treatment Outcome</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkU1v1DAYhC0EotuWH8AFReLSi-H1V2wfqwpKpUpc6NnyOs6uq8RO7eSQf4-3KQghIXHyYZ6ZV-NB6D2BTwRAfi4AlHEMhGPCBMfrK7QjnFFMNIXXaFdlhZnmcIbOS3kEACaZfIvOKJcSdAs79HQ9uHRMQzP57JbZRp-W0kS_5DSsJZQm9c189E2Zjj6myQ52DtE3BxsPQ0ixCfFZHm20Bz_6OJ8M2ffZujnltXHZxpBwb12w9YgN8RK96e1Q_LuX9wI9fP3y4-Ybvv9-e3dzfY8dZ2rGjvQtcVIL0VFJGeG6Z51QkmovwYPY7zsmla61RbdXYLVsO06JdBJaJzrGLtDVljvl9LT4MpsxFOeHYetoiBBccy1a-h8oVy1TSsmKfvwLfUxLjrXIM0XaVjBRKbJRLqdS6neYKYfR5tUQMKfpzDadqdOZ03RmrZ4PL8nLfvTdb8evrSpAN6BUKR58_uP0P1N_Ao15pD0</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Kastler, Adrian</creator><creator>Cadel, Gilles</creator><creator>Comte, Alexandre</creator><creator>Gory, Guillaume</creator><creator>Piccand, Veronique</creator><creator>Tavernier, Laurent</creator><creator>Kastler, Bruno</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20140701</creationdate><title>Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain</title><author>Kastler, Adrian ; Cadel, Gilles ; Comte, Alexandre ; Gory, Guillaume ; Piccand, Veronique ; Tavernier, Laurent ; Kastler, Bruno</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-c1f61c7955d2723149f3d58729e70e05bbd37893545db80a976d4217c706c5d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alcohol</topic><topic>Chronic Pain - diagnostic imaging</topic><topic>Chronic Pain - therapy</topic><topic>Disease management</topic><topic>Ethanol - therapeutic use</topic><topic>Face</topic><topic>Facial Pain - diagnostic imaging</topic><topic>Facial Pain - therapy</topic><topic>Female</topic><topic>Head and Neck Radiology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nerve Block - methods</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Pain management</topic><topic>Radiography, Interventional - methods</topic><topic>Radiology</topic><topic>Sphenopalatine Ganglion Block - methods</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kastler, Adrian</creatorcontrib><creatorcontrib>Cadel, Gilles</creatorcontrib><creatorcontrib>Comte, Alexandre</creatorcontrib><creatorcontrib>Gory, Guillaume</creatorcontrib><creatorcontrib>Piccand, Veronique</creatorcontrib><creatorcontrib>Tavernier, Laurent</creatorcontrib><creatorcontrib>Kastler, Bruno</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kastler, Adrian</au><au>Cadel, Gilles</au><au>Comte, Alexandre</au><au>Gory, Guillaume</au><au>Piccand, Veronique</au><au>Tavernier, Laurent</au><au>Kastler, Bruno</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>56</volume><issue>7</issue><spage>589</spage><epage>596</epage><pages>589-596</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24770960</pmid><doi>10.1007/s00234-014-1354-y</doi><tpages>8</tpages></addata></record> |
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| ispartof | Neuroradiology, 2014-07, Vol.56 (7), p.589-596 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aged, 80 and over Alcohol Chronic Pain - diagnostic imaging Chronic Pain - therapy Disease management Ethanol - therapeutic use Face Facial Pain - diagnostic imaging Facial Pain - therapy Female Head and Neck Radiology Humans Imaging Male Medicine Medicine & Public Health Middle Aged Nerve Block - methods Neurology Neuroradiology Neurosciences Neurosurgery Pain management Radiography, Interventional - methods Radiology Sphenopalatine Ganglion Block - methods Tomography, X-Ray Computed - methods Treatment Outcome |
| title | Alcohol percutaneous neurolysis of the sphenopalatine ganglion in the management of refractory cranio-facial pain |
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