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.
Abstract Below:
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.
Author information
1
Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain.
2
Institut d Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
3
Department of Otorhinolaryngology, Hospital Comarcal d’Inca, Mallorca, Spain.
4
Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Catalonia, Spain.
5
Unidad Alergo Rino, Centro Medico Teknon, Barcelona, Catalonia, Spain.
Abstract
BACKGROUND:
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.
METHODOLOGY:
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.
RESULTS:
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.
CONCLUSIONS:
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