The pterygopalatine ganglion (sphenopalatine ganglion) is the largest parasympathetic ganglion of the head, located in the pterygopalatine fossa below the maxillary nerve. It relays parasympathetic secretomotor fibres to the lacrimal gland (via the zygomatic and lacrimal nerves), and to the mucous glands of the nasal cavity, palate, and nasopharynx. It also carries sensory fibres from these regions passing through to the maxillary nerve.
The pterygopalatine ganglion is the target for sphenopalatine ganglion block, used for cluster headache, migraine, and trigeminal neuralgia pain relief, accessible transnasally with a cotton-tipped applicator or needle at the lateral nasal wall posterior to the middle turbinate. Stimulation of the ganglion produces lacrimation and nasal congestion. Neuromodulation of the sphenopalatine ganglion using an implantable device is an emerging therapy for chronic cluster headache.
The pterygopalatine ganglion mediates the autonomic features of cluster headache (lacrimation, rhinorrhea, conjunctival injection) and its block with local anaesthetic via the transnasal approach can abort acute cluster attacks and reduce headache frequency in some patients.
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