Clinical trial NCT06496841: Transnasal Versus Suprazygomatic SPG Block in Persistant Idiopathic Facial Pain
Official title: A Comparison of Transnasal Versus Ultrasound-guided Suprazygomatic Approaches for Sphenopalatine Ganglion Blocks in Persistent Idiopathic Facial Pain
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Headache
Persistent Idiopathic Facial Pain
Keywords: headache
ultrasonography
sphenopalatine ganglion block
Persistent Idiopathic Facial Pain
Lead sponsor: Diskapi Teaching and Research Hospital
Sponsor class: OTHER
First posted: 2024-07-11
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Male and female patients who underwent transnasal or ultrasound-guided suprazygomatic sphenopalatin ganglion block for persistant idiopathic facial pain

Brief summary: The International Headache Society defines persistent idiopathic facial pain (PIFP) as persistent facial pain that does not have the characteristics of cranial neuralgia, is blunt, persistent, persistent, bothersome and not attributable to another disorder. The management of persistent idiopathic facial pain (PIFP) is complex. The sphenopalatine ganglion (SPG) has been the target of interventional treatment of many facial pain syndromes. The sphenopalatine ganglion can be accessed by transnasal access and ultrasound or scopy guidance. In this study, datas compared the efficacy of transnasal approach and ultrasound-guided suprazigomatic approach in sphenopalatine ganglion block in patients with persistent idiopathic facial pain.

Detailed description: Patients with chronic head and facial pain are frequently referred to us and some of these patients are persistent idiopathic facial pain patients who do not respond to conservative treatment. Various interventional treatment modalities can be applied to these patients. One of the treatments we frequently apply is sphenopalatine ganglion (SPG) blockage, which has an important place in the pathogenesis of chronic headache. The SPG is the target area for the treatment of cluster headache, migraine, postherpetic neuralgia, trigeminal neuralgia and other atypical facial pain syndromes due to its anatomical localisation and its role in the trigemino-cervical reflex. Although there are various techniques for SPG block, the simplest and most easily applicable is the transnasal approach and the traditional method is to apply a block with a cotton-tipped swab. Various local anaesthetics can be used, the most commonly used local anaesthetic is 2-3 ml of 2% or 10% lidocaine, usually administered through one nostril for 30 minutes. It is also possible to access SPG via the suprazygomatic route, and studies have shown that SPG block applied via the suprazygomatic route provides effective treatment of chronic headaches. In ultrasound-guided SPG block, after visualising the pterygopalatine fossa with USG, 3-4 mL of 2% lidocaine is administered to the area and blockage is achieved.

Our study was designed retrospectively. The primary aim of the study was to compare the efficacy of transnasal and suprazigomatic routes based on Numerical Rating Scale (NRS) pain scores by reviewing the files of patients who underwent sphenopalatine ganglion block for persistent idiopathic facial pain. The pain scores recorded before the procedure and one and four weeks after the procedure will be compared.

In this study, primary aim is to evaluate the efficacy of these two treatment modalities, with retrospectively evaluate the Visual Analogue Scale (VAS) score, HIT-6 (Headache Impact Test-6) score and headache diary data of the patients who have previously undergone these treatments in the pain clinic.

Eligibility criteria: Inclusion Criteria:

* Diagnosis of persistent idiopathic facial pain according to ICHD-3 beta criteria
* Moderate to severe pain (pain of 6 or more on a numeric pain scale of 0-10)
* Persistence of pain for more than 6 months
* Pain unresponsive to conservative methods

Exclusion Criteria:

* Presence of secondary headache (tumor, bleeding, stroke, etc.)
* Cognitive impairment
* Hepatic or renal insufficiency
* Local or systemic infection
* Coagulopathy
* Patient refusal to accept treatment

Primary outcomes:
measure: Numerical Rating Scale (NRS)
timeFrame: Change from baseline to 1st hour, 1st week and 4th weeks after treatment
Secondary outcomes:
measure: HIT-6 (Headache impact test)
timeFrame: Change from baseline to 1st hour, 1st week and 4th weeks after treatment
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Ankara Etlik City Hospital
state: Yenimahalle
Study officials:
affiliation: Diskapi Teaching and Research Hospital
name: Ömer Taylan Akkaya, MD
role: STUDY_DIRECTOR
affiliation: Diskapi Teaching and Research Hospital
name: Ezgi Can, MD
role: PRINCIPAL_INVESTIGATOR
References: