Neurolysis of the trigeminal and sphenopalatine ganglions.

Facial pain of trigeminal and sphenopalatine ganglion origin is the bain of existence for thousands of people. Treatment protocols typically begin with oral medication, usually anticonvulsants, and may progress to percutaneous and open surgical procedures. Several new medications show promise as alternatives to carbamazepine, which has been the standard first-line treatment (trigeminal neuralgia), while electromagnetic pulsed radiofrequency and gamma knife surgery are new options when the surgical route is warranted. This article will examine the anatomy of the trigeminal and sphenopalatine ganglions. Indications for neurolysis and neurolytic options will be discussed. Efficacy of the various neurolytic techniques will be thoroughly reviewed.