Update in Sphenopalatine Ganglion Block Target Headaches

The session reviews the sphenopalatine ganglion (SPG), its anatomy, functions, and role in pain syndromes like cluster headaches, trigeminal neuralgia, and migraines. Located in the pterygopalatine fossa, SPG integrates parasympathetic, sympathetic, and sensory fibers. Pathophysiology involves neurogenic inflammation triggering severe headache symptoms. Interventional options include SPG blocks (most evidence-based), radiofrequency ablation, and neuromodulation. Approaches range from topical intranasal methods (simple, low-risk but indirect) to transnasal, transoral, and image-guided techniques (more precise but riskier). Neuromodulation offers promising results but is device-dependent. Emphasis is on evidence-based indications, repetitive blocks before irreversible lesions, and careful patient selection—especially avoiding aggressive interventions in younger patients.