A new study in Rhinology concluded that Sphenopalatine Ganglion Blocks with Lidocaine was a safe procedure for treating patients with Facial Flushing and or CranioFacial Hyperhydrosis (CFH). Significant improvement after lidocaine injection lasted 6 months.
This was a small study but it is great news for patients. who suffer from facial flushing and/or hyperhidrosis.
This is probably another perfect use for Self-Administered SPG Blocks. It is interesting that SPG Blocks are also effective for vasomotor rhinitis. Secretory glands in the head as well.
Rhinology. 2019 Sep 2. doi: 10.4193/Rhin19.119. [Epub ahead of print] Assessment of craniofacial hyperhidrosis and flushing by sphenopalatine blockade – a randomized trial.
Lehrer E1,2, Nogues A1,2, Jaume F3, Mullol J1,2,4, Alobid I1,2,4,5.
Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain.
Institut d Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
Department of Otorhinolaryngology, Hospital Comarcal d’Inca, Mallorca, Spain.
Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Catalonia, Spain.
Unidad Alergo Rino, Centro Medico Teknon, Barcelona, Catalonia, Spain.
Craniofacial hyperhidrosis (CFH) and flushing express nervous system autonomic dysfunction. Available reference treatments lack good compliance. The study objective was to investigate variations of CFH/flushing after two methods of sphenopalatine ganglion (SPG) blockade.
CFH patients (n=25) were randomized in a ratio of 1:3 in two groups; 1) endoscopic application of topical lidocaine over SPG (TL; n=7); 2) endoscopic injection of lidocaine in the SPG (IL; n=18). CFH, flushing, rhinorrhoea, nasal obstruction, and smell detection were scored by Visual Analogue Scale (VAS). Nasal endoscopy, acoustic rhinometry, mucociliary transport test, smell/taste test, Schirmer test, Short Form-12, Chronic Skin Diseases Questionnaire, and Skin Satisfaction Questionnaire were also performed at visit 0, 1, 3 and 6 months.
At baseline, groups reported similar CFH VAS (TL: 89.3 plus or minus 17.5mm; IL: 85.7 plus or minus 22.1mm) or flushing VAS (TL: 52.7 plus or minus 30mm; IL: 59 plus or minus 33.8mm). After 6 months, the least squares mean of CFH VAS in IL was -38.1 (-47.3 to -28.9) compared to TL 1.9 (-12.2 to 15.9). However, flushing VAS did not improve. Any rhinological measure nor quality of life test showed significant changes. One patient presented controlled epistaxis intraoperatively during IL.
This preliminary study shows the sphenopalatine blockade injection as a safe procedure. Patients with CFH or flushing had significant improvement after lidocaine injection which lasted 6 months. Due to the small sample and the lack of objective measures more studies are needed.
PMID: 31475696 DOI: 10.4193/Rhin19.119