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MaverickDMD
Member since Dec-14-07
84 posts |
Apr-02-08, 06:44 PM (CST) |
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3. "RE: Sphenopalatin Ganglion Block???"
In response to message #2
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The crying reference was to the neural blockage of the lacrimal (tear) gland, i.e., no tears would be made if the neural stimulus were blocked by anesthesia. The pterygopalatine ganglion is a relay area between the facial nerve (VII) and the maxillary branch of the trigeminal nerve(V). It does not carry any sensory nerves so it would be odd to use a block here to reduce pain in the upper jaw. However, the PP ganglion and perhaps the otic ganglion (again nonsensory) are thought to be involved in the ice cream headache phenomenon which hurts like hell as we all know. So it is probably that the PP ganglion when excited will create sensory phenomena in neighbouring areas much like when getting the wind knocked out of you -- the celiac ganglion, aka, the solar plexus, causes a cascade of nerve impulses to many areas of the body. I followed your posted links and noted that the prescribed procedure involved what appears to be EMLA (prilocaine and lidocaine) gel to get a topical effect through the mucosa to the ganglion itself. Again, from what I recall about your particular plight, you're having issues in the lower jaw not the upper, so in my humble view, I found it questionable as to the efficacy you would have in a V3 injury. But again, I'm not a neurologist so what the hell do I know. One last thing that might be interesting is that in particular to lingual nerve injuries that produce dysesthesias, it is often thought to be linked to the chorda tympani injury, the branch of VII that carries taste fibers but also carries parasympathetic fibers that have been implicated in the substance P and glutamic acid mediated pain pathways, and not the lingual nerve itself that causes the bizarre pain episodes. Since the pterygopalatine ganglion relays between parasympathetic afferents of VII and V it may have been a suggestion for treatment. (But again, don't you have an IA problem and not a lingual nerve problem?). |
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