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Russell S Frautschi, Brianna Halasa, Susan Orra, Karolina Mlynek, Charles P Steiner, Francis A Papay
The sphenopalatine ganglion is an extracranial neural structure within the pterygopalatine fossa. Modulation of this region via implantation of a neuromodulatory device presents a novel therapy for the treatment of facial and head pain. Yet sex, race, and genetic factors contribute to morphological variations between individuals. This study defines the standards and variations of the bony landmarks surrounding the pterygopalatine fossa. One hundred dry skulls were analyzed from the Hamann-Todd osteological collection...
October 2016: Journal of Craniofacial Surgery
Rolfe M Radcliffe, Yasmine Messiaen, Nita L Irby, Thomas J Divers, Curtis W Dewey, Katharyn J Mitchell, Lauren V Schnabel, Abraham J Bezuidenhout, Peter V Scrivani, Norm G Ducharme
OBJECTIVE: To report a transnasal, endoscopically guided ventral surgical approach for accessing the cranial and caudal segments of the sphenopalatine sinus for mass removal in a horse. STUDY DESIGN: Case report. ANIMAL: Adult horse with acute onset blindness referable to a soft tissue mass within the sphenopalatine sinus. CLINICAL REPORT: A 7-year-old Warmblood gelding presented with a history of running into a fence and falling...
October 12, 2016: Veterinary Surgery: VS
Sheffield Kent, Gregory Mehaffey
STUDY OBJECTIVE: To demonstrate a possible alternative treatment for postdural puncture headache (PDPH). DESIGN: Postdural puncture headache is a common complication associated with neuraxial anesthesia and unintentional dural puncture. Epidural blood patch (EBP) is the standard therapy for PDPH but has risks including pain, dural puncture, and infection. Transnasal sphenopalatine ganglion block (SPGB) has been successfully used to treat migraine, cluster headache, and trigeminal neuralgia...
November 2016: Journal of Clinical Anesthesia
Kevin D'Ostilio, Delphine Magis
Chronic primary headaches are widespread disorders which cause significant quality of life and socioprofessional impairment. Available pharmacological treatments have often a limited efficacy and/or can generate unbearable side effects. Electrical nerve stimulation is a well-known non-destructive method of pain modulation which has been recently applied to headache management. In this review, we summarise recent advances in invasive and non-invasive neurostimulation techniques targeting pericranial structures for the treatment of chronic primary headaches, chiefly migraine and cluster headache: occipital nerve, supraorbital nerve, vagus nerve, and sphenopalatine ganglion stimulations...
November 2016: Current Pain and Headache Reports
Vivek Loomba, Aman Upadhyay, Hirsh Kaveeshvar
UNLABELLED: Percutaneous radiofrequency ablation (RFA) of the sphenopalatine ganglion (SPG) has been shown to be an effective modality of treatment for patients with intractable chronic cluster headaches (CHs). While the use of fluoroscopy for RFA of the SPG is common, to our knowledge there are no documented cases of procedures using cone beam computed tomography (CBCT) for image guidance. We present a case report of a patient suffering from chronic intractable CH with complete long-lasting relief after RFA of the SPG using CBCT...
September 2016: Pain Physician
Anna Steinberg, Simona D Frederiksen, Frank W Blixt, Karin Warfvinge, Lars Edvinsson
No abstract text is available yet for this article.
December 2016: Journal of Headache and Pain
Kyun Bum Lee, Young Sun Jeon, Seung-Kyu Chung, Sung Kyun Kim
The surgical term "turbinectomy" encompasses many variations in the location and extent of removal. As a systemic approach to consider the negative impact of middle turbinectomy(MT), such as the excessive removal of turbinate, airflows inside a pre-surgery model and a series of virtual surgery models were numerically analyzed and compared. These models simulate three variations of partial MT(three bilateral and three unilateral) with varying resection volume and location. Each middle turbinectomy results in alterations of flow and thermal parameters, such as nasal resistance (NR), velocity, temperature, wall shear stress(WSS) and wall heat transfer(WHT)...
October 1, 2016: Computers in Biology and Medicine
Anna Steinberg, Simona D Frederiksen, Frank W Blixt, Karin Warfvinge, Lars Edvinsson
BACKGROUND: Migraine and Cluster Headache (CH) are two primary headaches with severe disease burden. The disease expression and the mechanisms involved are poorly known. In some attacks of migraine and in most attacks of CH, there is a release of vasoactive intestinal peptide (VIP) originating from parasympathetic cranial ganglia such as the sphenopalatine ganglion (SPG). Patients suffering from these diseases are often deprived of effective drugs. The aim of the study was to examine the localization of the botulinum toxin receptor element synaptic vesicle glycoprotein 2A (SV-2A) and the vesicular docking protein synaptosomal-associated protein 25 (SNAP25) in human and rat SPG...
December 2016: Journal of Headache and Pain
Yukitomo Ishi, Hiroyuki Kobayashi, Hiroaki Motegi, Shogo Endo, Shigeru Yamaguchi, Shunsuke Terasaka, Kiyohiro Houkin
BACKGROUND: Compared with surgical resection, endoscopic transsphenoidal surgery (TSS) for cholesterol granuloma (CG) in the petrous apex (PA) is associated with local recurrence due to obstruction of the drainage route. We present a detailed procedure of an endoscopic TSS using pedicle vascularized nasoseptal flap (PVNF). METHODS: A 40-year-old woman with a history of repeated surgery for left tympanitis was referred to our institution. Neurological examination revealed severe hearing loss in the left ear...
August 20, 2016: Neurologia i Neurochirurgia Polska
Jed H Assam, Thomas H Quinn, Oleg N Militsakh
INTRODUCTION: Variations in the operative situation for complex head and neck defect reconstructions resulting from mechanisms such as trauma, oncologic resection, and prior radiation exposure can result in situations of a vessel-depleted neck. This requires an awareness of alternate, innovative options for use in reconstructive repairs. The purpose of this study was to provide characterization of the third segment of the maxillary artery necessary to consider its use as a recipient vessel in free flap repair of complex midface defects...
August 29, 2016: Microsurgery
Francisco J D MacArthur, Gerald W McGarry
With the development of endonasal flaps, an understanding of the arterial anatomy of the nasal cavity has become increasingly important for clinicians. Despite this, there is a lack of current, accurate overviews in the literature. We have used both endoscopic and gross dissection of six fresh frozen cadaveric heads, alongside a literature review, to produce a comprehensive description of the anatomy. Four heads had their arterial systems injected with red latex. Three injected and two uninjected heads were dissected endoscopically, to provide a total of seven sides...
August 27, 2016: European Archives of Oto-rhino-laryngology
Helen Triantafyllidi, Chrysa Arvaniti, Leonidas Palaiodimos, Stefanos Vlachos, Antonios Schoinas, Chrysanthi Batistaki, Georgia Kostopanagiotou, John Lekakis
BACKGROUND: Sphenopalatine ganglion (SPG), an extracranial structure, is connected with the central nervous system (CNS) through sympathetic and parasympathetic nerves. We hypothesized that SPG block through sympathetic nerves anesthesia might decrease blood pressure (BP) in recently diagnosed and never treated middle-aged patients with essential hypertension. METHODS: We performed SBG block in 22 hypertensive patients (mean age 45±12years, 15 men). All patients have been subjected to 24hour ambulatory blood pressure monitoring a week prior the procedure as well as in a period of 21-30days after the SBG block in order to estimate differences in 24h average systolic (24h SBP) and diastolic blood pressure (24h DBP), daytime, nighttime, pre-awake and early morning SBP and DBP as well as BP load...
November 15, 2016: International Journal of Cardiology
Ivan Pašalić, Ines Trninić, Jakob Nemir, Hrvoje Jednačak, Kamelija Žarković, Goran Mrak
Angiofibromas are rare tumors of the head and neck that mostly occur in the sphenopalatine region. We present a case of angiofibroma in a young male patient with an unusual and extremely rare localization, which to our knowledge has not been described before. It was situated in the tentorium and spread to the supratentorial and infratentorial regions. The patient initially presented with symptoms of increased intracranial pressure. After a diagnostic evaluation was done, the whole tumor was successfully removed using the supratentorial and infratentorial approach and the microsurgical technique...
2016: Pediatric Neurosurgery
Paulo Saraceni Neto, Leonardo Mendes Acatauassu Nunes, Fabio de Azevedo Caparroz, Luciano Lobato Gregorio, Rafael de Paula E Silva Felice de Souza, Juliana Caminha Simões, Eduardo Macoto Kosugi
BACKGROUND: In severe cases of epistaxis, in spite of several procedures described in the literature for its management, surgical treatment has been recognized by most authors as 1 of the most effective, especially when it includes ligation and/or electrocoagulation of the nasal branches of the sphenopalatine artery. The objective of this study is to determine the importance of ethmoid crest resection during sphenopalatine artery surgery, in the management of severe epistaxis. METHODS: We report a double-blinded randomized clinical trial, in which intervention was the ethmoid crest resection during electrocoagulation of the sphenopalatine artery...
August 11, 2016: International Forum of Allergy & Rhinology
V G Borodulin, S V Filimonov
This article deals with the application of the sphenopalatine ganglion blockade in the present-day rhinological practice. The blockade is known to arrest the propagation of pain impulses from the nose and break the rhinocardiac reflex arc. Moreover, it is involved in bleeding control during nasal surgery. The method for the blockade via the palatal route using the modern equipment and imaging techniques is described. The objective of the present study was to evaluate the effectiveness and safety of the blockade of sphenopalatine ganglionthrough the palatal approach in the patients who had undergone septoplasty under general and local anesthesia...
2016: Vestnik Otorinolaringologii
O C Wakelam, P A Dimitriadis, J Stephens
INTRODUCTION It is standard practice in the UK that if conservative measures or chemical cautery fail to control epistaxis, patients receive nasal packing which is often uncomfortable, requires admission and has well documented associated morbidity. Our study aims to evaluate the use of FloSeal haemostatic sealant in managing patients with epistaxis. MATERIALS AND METHODS Patients were identified from those referred with active epistaxis. A successful outcome was defined as complete haemostasis with FloSeal alone, with no further significant bleeding requiring admission or further interventions in the subsequent 7 days...
August 4, 2016: Annals of the Royal College of Surgeons of England
Bernadett Tuka, Nikoletta Szabó, Eszter Tóth, Zsigmond Tamás Kincses, Árpád Párdutz, Délia Szok, Tamás Körtési, Teréz Bagoly, Zsuzsanna Helyes, Lars Edvinsson, László Vécsei, János Tajti
BACKGROUND: Activation of the trigeminal-autonomic reflex, involving the trigeminal ganglion, the superior salivatory nucleus and the sphenopalatine ganglion (SPG) is crucial in the pathophysiology of cluster headache (CH). Since pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) is present both in the SPG and the trigeminal ganglion (TG) and its role in migraine has been described, our aim was to determine the plasma PACAP-38 levels in different phases of episodic CH (ECH)...
December 2016: Journal of Headache and Pain
Mads C J Barloese, Tim P Jürgens, Arne May, Jose Miguel Lainez, Jean Schoenen, Charly Gaul, Amy M Goodman, Anthony Caparso, Rigmor Højland Jensen
BACKGROUND: Cluster headache (CH) is a debilitating headache disorder with severe consequences for patient quality of life. On-demand neuromodulation targeting the sphenopalatine ganglion (SPG) is effective in treating the acute pain and a subgroup of patients experience a decreased frequency of CH attacks. METHODS: We monitored self-reported attack frequency, headache disability, and medication intake in 33 patients with medically refractory, chronic CH (CCH) in an open label follow-up study of the original Pathway CH-1 study...
December 2016: Journal of Headache and Pain
Matthew S Robbins, Amaal J Starling, Tamara M Pringsheim, Werner J Becker, Todd J Schwedt
BACKGROUND: Cluster headache (CH), the most common trigeminal autonomic cephalalgia, is an extremely debilitating primary headache disorder that is often not optimally treated. New evidence-based treatment guidelines for CH will assist clinicians with identifying and choosing among current treatment options. OBJECTIVES: In this systematic review we appraise the available evidence for the acute and prophylactic treatment of CH, and provide an update of the 2010 American Academy of Neurology (AAN) endorsed systematic review...
July 2016: Headache
Kuiji Wang, Luquan Chen, Yang Wang, Chengshuo Wang, Luo Zhang
The study aimed to assess the effects of Sphenopalatine ganglion (SPG) acupuncture on nasal ventilation function and autonomic nervous system in health volunteers. 39 healthy subjects were randomly assigned to either active SPG acupuncture group (AA group) or sham-SPG acupuncture group (SA group). All subjects were assessed for self-reported nasal ventilation, nasal patency (nasal airway resistance (NAR) and nasal cavity volume (NCV), exhaled nasal nitric oxide (nNO), and neuropeptides (substance P(SP), vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY)) in nasal secretions at baseline, 30 minutes, 2 hours, and 24 hours after acupuncture...
2016: Scientific Reports
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