The posterior nasal nerves are branches of the maxillary nerve (V2) via the pterygopalatine ganglion, exiting through the sphenopalatine foramen to supply the posterior nasal cavity including the posterior nasal septum, the posterior superior turbinate, and the nasopharyngeal roof. The largest branch is the nasopalatine nerve (crossing the nasal septum to the incisive canal). The posterior inferior nasal nerves supply the posterior inferior turbinate.
| Origin | Maxillary nerve (V2) via the pterygopalatine ganglion |
|---|---|
| Course | Enter the nasal cavity through the sphenopalatine foramen and divide into lateral branches to the conchae and medial branches to the septum, with inferior branches arising from the greater palatine nerve |
| Sensory |
|
The sphenopalatine foramen and the posterior nasal nerves are the target of sphenopalatine ganglion block for acute migraine, cluster headache, and nasal pain. Endoscopic sphenopalatine artery ligation for posterior epistaxis also addresses the accompanying posterior nasal nerve territory. The posterior nasal nerves supply the Kiesselbach's plexus on the nasal septum via the nasopalatine branch, explaining why nasal septal anaesthesia is achieved by sphenopalatine block. Vidian neurectomy (division of the nerve of the pterygoid canal) targets the parasympathetic root of the pterygopalatine ganglion for refractory rhinitis.
Transnasal sphenopalatine ganglion block for acute migraine involves topical application of local anaesthetic to the posterior nasal mucosa at the sphenopalatine foramen, anaesthetising the posterior nasal nerve territory and providing headache relief through interruption of trigeminoparasympathetic pathways.
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