The Pterygopalatine Ganglion and Its Role in Various Pain Syndromes: from Anatomy to Clinical Practice
REVIEW ARTICLE The Pterygopalatine Ganglion and its Role in Various Pain Syndromes: From Anatomy to Clinical Practice Maria Piagkou, MD, MSc, PhD*; Theano Demesticha, MD, PhD†; Theodore Troupis, MD, PhD*; Konstantinos Vlasis, MD, PhD*; Panayiotis Skandalakis, MD, PhD*; Aggeliki Makri, MD*; Antonios Mazarakis, MD, PhD*; Dimitrios Lappas, MD, PhD*; Giannoulis Piagkos, MD*; Elizabeth O Johnson, MD, PhD* *Department of Anatomy, Medical School, University of Athens, Athens; †Department of Anesthesiology, Metropolitan Hospital, P. Faliro, Greece n Abstract: The postsynaptic fibers of the pterygopalatine SPGB, the advantages, disadvantages, and modifications of or sphenopalatine ganglion (PPG or SPG) supply the lacri- the available methods for blockade are discussed.n mal and nasal glands. The PPG appears to play an important role in various pain syndromes including headaches, trigem- Key Words: pterygopalatine ganglion, sphenopalatine inal and sphenopalatine neuralgia, atypical facial pain, neuralgia, craniofacial pain syndrome, sphenopalatine gan- muscle pain, vasomotor rhinitis, eye disorders, and herpes glion block infection. Clinical trials have shown that these pain disor- ders can be managed effectively with sphenopalatine ganglion blockade (SPGB). In addition, regional anesthesia of the distribution area of the SPG sensory fibers for nasal INTRODUCTION and dental surgery can be provided by SPGB via a transna- Broad morphological and functional knowledge of the sal, transoral, or lateral infratemporal approach. To arouse head anatomy is essential for neurology, neurosurgery, the interest of the modern-day clinicians in the use of the and maxillofacial surgery practice. Nevertheless, there are areas and structures that still have not been Address correspondence and reprint requests to: Lecturer Dr. Maria described or depicted sufficiently, owing to their small N.
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