Evidence map›Paper›PMID 41735560›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Endoscopic transnasal sphenopalatine ganglion block for chronic craniofacial pain.

David T Liu, Pooya Roozdar, Erik Chan, Michael Yong, Meredith J Barad, Xiang Qian, Peter H Hwang, Michael T Chang

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David T LiuDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, Stanford, CA, 94305, USA.
Pooya RoozdarDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, Stanford, CA, 94305, USA.
Erik ChanDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, Stanford, CA, 94305, USA.
Michael YongDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, Stanford, CA, 94305, USA.
Meredith J BaradDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, USA.
Xiang QianDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, USA.
Peter H HwangDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, Stanford, CA, 94305, USA.
Michael T ChangDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, Stanford, CA, 94305, USA. michael.t.chang@stanford.edu.ORCID http://orcid.org/0000-0001-9519-5880

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChronic craniofacial pain is challenging to treat, with varied outcomes from existing treatments. This study explores the use of an endoscopic transnasal technique for targeting the sphenopalatine ganglion (SPG). The objective was to assess the efficacy and safety of repeated endoscopic transnasal submucosal liposomal bupivacaine (Exparel®) injections into the SPG for managing craniofacial pain.

methodsIn this prospective, longitudinal, open-enrollment trial, 11 patients with chronic craniofacial pain were treated at a tertiary center. Patients who experienced symptom relief after an initial bupivacaine challenge were included. Repetitive endoscopic transnasal submucosal SPG blocks (SPGB) with liposomal bupivacaine were then administered in the office under local anesthesia using a spinal needle. Pain was assessed with a 10-item questionnaire at baseline and one day, one week, and one month post-injection.

resultsOf the 82 injections performed, 81 were successful (98.8%). Analysis of variance showed significant improvements in pain scores for average pain (p < 0.01), worst pain (p < 0.01), and least pain (p < 0.01) in the last 24 h at day one and one week post-treatment compared to baseline. Additionally, pain-related quality of life measures, including eating habits, annoyance, and sleep, showed significant improvements (all p < 0.01). Five minor adverse events were reported: transient diplopia (n = 2), headache/facial pain (n = 1), bleeding at the injection site (n = 1), and nasal irritation (n = 1).

conclusionEndoscopic transnasal injection of bupivacaine into the SPG appears to be a safe and effective procedure for providing significant pain relief in patients with chronic craniofacial pain.

Indexed as

Anesthetics, LocalBupivacaineChronic PainEndoscopyFacial PainSphenopalatine Ganglion BlockAdultAgedFemaleHumansLongitudinal StudiesMaleMiddle AgedPain MeasurementProspective StudiesTreatment OutcomeAnesthetics, LocalBupivacaineBupivacaineCraniofacial painExparelSphenopalatine ganglion block

Identifiers

PMID41735560

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.