This recent paper focuses on the use of Sphenopalatine Ganglion Block to improve surgical visibility during endoscopic surgery.  It discusses the low risk of utilizing these 00 year old blocks first describe by Greenfield Sluder in 1908.  Dr Sluder later wrote the medical textbook Nasal Neurology.  A recent article has shown that SPG Blocks (SPGB) reduce incidence of nausea and vomiting during nasal endoscopic surgery.

These blocks are used to treat acute and chronic headaches, migraines, cluster headaches, sinus pain and sinus headaches.  There has been a recent move to consider sinus headaches migraines but it may be more accurate to call migraines secondary sinus headaches.

All headaches and migraines are trigeminal nerve innervated.  The trigeminal nerve is often called the Dentist’s Nerve.  35 years ago I noted patients having relief of sinus pain and sinus headaches when the maxillary palate was anesthesized for tooth extraction with greater palatine foramen blocks.  In 1986 a patient brought me the book “Miracles on Park Avenue” which revealed the unusual practice of Dr Milton Reder a 90 year old ENT in NYC whose entire practice consisted of doing SPG Blocks to treat a wide variety of painful conditions with the “Miracle” nasal block.

This is when I learned about the wonders of the Sphenopaklatine Ganglion Block, a piece of “Forgotten Medicine” that was brought back largely because of the book “Miracles on Park Avenue”  It is interesting to note that in 1930 “Annals of Inter4nal Medicine” and article by Hiram Byrd reported on 10,000 SPG blocks on 2000 patients without adverse reactions.  These blocks gave miraculous relief from headaches, migraines, sinus pains, sinus headaches, facial pain, trigeminal neuralgia, all types of eye pain, lumbago pain and many other disorders.  How did the “Miracle Block” disappear and become part of forgotten medicine?

Pharmaceutical companies began to produce a wide variety of prescription pills and young physicians were never taught the old science.  This is the equivlant of forgetting Penicillin.  The following video is from a doctor who went into medicine because of the relief he experienced as a child with an Sphenopalatine Ganglion Block. Ubfortunately, he was never taught the science and eventually left medicine to become an artist because he could not help patients the way he was helped as a boy.

This video is from the day he discovered what an SPG Block was.

This second video is a disabled Israeli Veteran who had her Fibromyalgia treated with SPG Blocks.  She initially self administered them twice a day, then once a day, the twice a week and is maintained comfortably now using SPG Blocks twice a month.

Patients with chronic sinus issues can also consider utilization of Epigenetic Orthodontics/ orthopedics to grow the maxilla and sinus structures to improve health.

Clin Otolaryngol. 2018 Apr 29. doi: 10.1111/coa.13128. [Epub ahead of print]

Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta-analysis.



The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS).


The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946-2017).


Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta-analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared with the control group (MD -0.86; 95% CI -2.24, 0.51; P = .009). No adverse events related to LAB toxicity were reported.


Sphenopalatine ganglion LAB with adrenaline carries relatively low risk of morbidity, but may improve the quality of the surgical field in terms of bleeding. However, there are limitations of the study due to heterogeneity of methods, quality and size of the studies. Well-conducted large RCTs are needed using standardised inclusion criteria, balanced baseline characteristics of cohorts, and validated subjective and objective outcome measures.


anaesthetic; block; endoscopic; local; sinus; surgery