The Sphenopalatine Ganglion (SPG) lies in the Pterygopalatine fossa. Blocking the SPG can give miraculous relief and amazing positive results for treating migraines, cluster headaches and autonomic syndromes.

Can any of these pathologies be associated with movement of the cranial bones or pressures placed on the Sphenopalatine Ganglion.

This video is an example of the miraculous effects of SPG Blocks as part of a comprehensive treatment plan.

The answer is probably yes according to material published in an article on Osteopathic Manipulative Treatment.

According to Wikipedia,” the pterygopalatine fossa (sphenopalatine fossa) is a fossa in the skull.
A human skull contains two pterygopalatine fossae — one on the left side, and another on the right side. Each fossa is a cone-shaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull, located between the pterygoid process and the maxillary tuberosity, close to the apex of the orbit.
It is the indented area medial to the pterygomaxillary fissure leading into the sphenopalatine foramen. It communicates with the nasal and oral cavities, infratemporal fossa, orbit, pharynx, and middle cranial fossa through eight foramina.” The borders are Anteriorly the posterior wall of the maxillary sinus. Posteriorly the Pterygoid process of the sphenoid bone. Inferiorly the Palatine bone and palatine canals. Superiorly the Inferior orbital fissure of the eye. Medially the Perpendicular plate of the palatine bone and Laterally is the Pterygomaxillary fissure.

The Pterygopalatine fissure is where the Suprazygomatic injection of the Sphenopalatine Ganglion Block is injected. The following two videos show the injection of the ganglion and then Dr Bosilajic describes the feeling of relaxation after the procedure.

The following structures pass through the fissure:
The Posterior superior alveolar nerve branch of the maxillary nerve and the termination of the maxillary artery (off external carotid artery)

“The pterygopalatine fossa is a bilateral, cone-shaped depression extending deep from the infratemporal fossa all the way to the nasal cavity via the sphenopalatine foramen.” from Wikipedia

TeachMeAnatomy.com states “It is located between the maxilla, sphenoid and palatine bones, and communicates with other regions of the skull and facial skeleton via several canals and foramina. Its small volume combined with the numerous structures that pass through makes this a complex region…… The foramen rotundum connects the pterygopalatine fossa to the middle cranial fossa.”

An article on Osteopathic Manipulative Treatment in the J Clin Aesthetic Dermatol. 2012 OCT;5(10): 24-32 appears to address this issue. It is addressed in a section on Dysesthesia Syndromes. I have that reprinted in this text. Any comments by me will be seen as all capitals.

Dysesthesia syndromes. Burning mouth syndrome (BMS). BMS is a chronic pain syndrome characterized by burning or stinging feelings affecting the oral mucosa in the absence of clinically detectable signs.
BURNING MOUTH SYNDROME IS A MAJOR CONUNDRUM IN DENTISTRY AND IT IS USUALLY IDIOPATHIC IN NATURE. SOME CASES HAVE BEEN TREACKED TO ALLERGIES TO MOUTHWASH, TOOTHPASTE OR OTHER ALLERGENS. BMS usually affects middle-aged women and commonly presents with a “symptomatic triad” of chronic, unremitting pain, dysgeusia, and xerostomia. IT IS FREQUENTLY SEEN WITH SEVERE EMOTIONAL UPSETS AND OTHER PSYCHOLOGICAL ISSUES AND ALWAYS CREATES MAJOR INTERFERENCES IN EVERYDAY LIFE. Current pharmacotherapy consists mostly of antidepressants, antipsychotics, antiepileptics, and analgesics. Due to the unwanted side effects of pharmacotherapy, OMT may serve as supplemental treatment for BMS.
THERE IS ONE TOPICAL AGENT THAT HAS SHOWN TO BE REMARKABLY SUCCESSFUL FOR SOME PATIENTS IN MY PRACTICE. THE PRODUCT IS GELCLAIR AND IT IS DESIGNED FOR TREATING ORAL MUCOCITIS THAT ARE SECONDARY TO CHEMOTHERAPY AND RADIATION. IT IS NORMALLY DILUTED BUT WE USE IT OFF LABEL IN UNDILUTED FORM .

Research in the last decade has suggested there is an underlying autonomic nerve disorder of the oral cavity in patients with BMS due to dysfunction of the sensory trigeminal nervous system.21 This evidence is supported by the presence of neuropathic symptoms, including pain, dysgeusia, and xerostomia. It has also been suggested that BMS results from a reduction in salivary output.18,22,23 if the etiology of BMS were proven to be of trigeminal nerve origin, cranial osteopathic manipulation to normalize neural function might be beneficial. This would require more definitive research into the etiology of BMS itself as well as the true effects of cranial manipulation, which have so far remained elusive in well-controlled clinical research trials.

I work closely with Dr Mark Freund a doctor trained in Chirpopractic manipulations of cranial (Dr Bob Walker) and cervical bones including Atlas-Orthoganol Chiropractic, Chirodontics, SOT Chiropractic (Dr Charles Blum).

These therapies closely relate to treatment of TMJ disorders with Neuromuscular Dentistry and the orthopedic growth of maxillas and pneumpedic growth of airway as taught by Dr David Singh that are done with the DNA and RNA appliances. This patient reports incredible changes after wearing DNA Appliance, some of these are due to a larger airway but some are likely due to orthopedic changes to the pterygopalatine fossa and effects on SPG.

“The presence of xerostomia in BMS also suggests the disease may involve hypofunctioning of the parasympathetic nervous system (PNS). Many OMT treatments target the PNS in order to normalize its activity.

SPHENOPALATINE GANGLION RELEASE MAY BE EFFECTIVE IF THE GANGLION IS IMPINGED ON BY PHYSICAL STRUCTURES MAKING UP THE WALLS OF THE PTERYGOPALATINE FOSSA. “Sphenopalatine ganglion release is a technique performed using the fifth finger to manually massage and stimulate the sphenopalatine ganglion located in the superior, posterior lateral area of the pharynx.”

THE MANIPULATION AND MOBILIZATION OF MAXILLARY BONES, TEMPORAL BONES AND SPHENOID BONES IS EASILY ACCOMPLISHED BY A SPECIALLY TRAINED CHIROPRACTOR OR OSTEOPATH. I HAVE ALSO TRAINED IN THESE TECHNIQUES BUT FEEL PATIENTS ARE USUALLY BETTER SERVED WITH DO or DC DOING THE ADJUSTMENT.

The sphenopalatine ganglion’s parasympathetic innervation derives from the facial nerve and contains sensory fibers from the trigeminal nerve. Stimulation of the ganglion may reduce xerostomia and pain associated with BMS by normalizing the activity of the PNS and sensory components of the trigeminal nerve.

It is the parasympathetic component that makes the SPG block effective for treating Fibromyalgia.

Sphenopalatine ganglion release may also benefit patients with other causes of xerostomia, such as Sjogren’s syndrome. The upper thoracic spine represents the sympathetic autonomic preganglionic origin of fibers that then synapse at the superior cervical ganglia and innervate the head and neck. Treating both the upper thoracic and cervical region will address dysfunction and its related nervous associations in those areas.”

This series of three videos are of a patient who could barely walk and was in severe debilitating pain in spite of massive dosages of narcotin pain medication.  These three videos take you from first day of treatment to six months later after getting offf methadone.

The Sphenopalatine Ganglion Block was featured in the book, “Miracles on Park Avenue”

Additional videos at: https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg/featured

J Clin Aesthet Dermatol. 2012 Oct; 5(10): 24–32.
PMCID: PMC3486778
Osteopathic Manipulative Treatment





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