- 1. ICCMO THE INTERNATIONAL COLLEGE OF CRANIOMANDIBULAR ORTHOPEDICS BUENOS AIRES MARCH 2017 • SPHENOPALATINE GANGLION BLOCKS • Ira L Shapira DDS, FICCMO, D,ABDSM, D,AAPM
- 2. Sphenopalatine Ganglion Pterygopalatine Ganglion Meckels Ganglion Nasal Ganglion Sluder’s Ganglion
- 3. Parasympathetic Ganglia of Head
- 4. Anatomy PterygoPalatine Fossa SphenoPalatine Ganglion • The Trigeminal Nerve is often called the Dentist’s Nerve. • The Sphenopalatine Ganglion also belongs to Dentistry and is intamately associated with the trigeminal nerve • Dentists are experts in the anatomy of the Trigeminal Nerve
- 5. PterygoPalatine Fossa Maxilla and Sphenoid Bone
- 6. Sluder’s Neuralgia Sphenopalatine Ganglion Neuralgia • SPG Block First described in 1908 by Sluder • Autonomic Trigeminal Cephalgia • Cluster Headache • TMJ Symptoms • Contact Headache
- 7. Positive Side Effects SPG Block • Decreased Blood Pressure • Decreased Anxiety • Feeling of Calm and Well Being • Increased sexual desire and response
- 8. History
- 9. Limbic System • The limbic system includes the thalamus, hypothalamus and other structures. • Limbic system appears to be the memory site of emotions, including Fear, Anger, Joy, Remorse and of course Pain • Pain is our emotional response to nociceptive input.
- 10. Flight or Fight Reflex Acute Stress Reaction Sympathetic Response • Preparation for Action • Release of Catecholamines • More blood flow to brain and muscles • Shut Down of Parasympathetics • Less blood to gut
- 11. Fight of Flight Response • Adrenal Medula Releases Catecholamines Epinephrine and Norepinephrine • Hans Selye: General Adaptation Syndrome • Stage 1: Alarm • Stage 2: Resistance • Stage 3: Exhaustion
- 12. Parasympathetic Response: This is where we Eat and Digest, Sexual Response, Orgasm, Post- Orgasmic Bliss. Survival as a Species rather than an Individual. Feelings of love and Attachment Warm feelings from Babies, Puppies and Kittens FEED AND BREED RESPONSE
- 13. Reticular Activating System The reticular activating system is receives input from all parts of the sensory system as well as the cerebrum. • Amplification of input particularly concern to NMD is the Trigeminal Nerve • The major function of this system is to control the arousal level of the brain. Part of Limbic System • This system secretes norepinephrine and dampens the many stimuli coming through it, so new and different stimuli can be recognized by the rest of the brain.
- 14. Hypothalamus • Part of Limbic System • Links Nervous System to Endocrine System and Pituitary Gland • Controls Body Temperature, Hunger, Thirst Satiety, • Fatigue, Sleep and Arousal, Circadian Rhythms: Suprachiasmatic Nucleus • Memory and Learning • Blood Pressure, Heart Rate, GI Mobility
- 15. Sphenocath & Allevio
- 16. TX-360 s
- 17. Transnasal cotton tipped Applicator