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头颈部神经节:对介入疼痛治疗医师的临床意义

The Ganglia of the Head and Neck: Clinical Relevance for the Interventional Pain Physician.

作者信息

Millhouse Paul W, Bloom Robert W, Beckstrand Jason N, McClure Matthew L, Eckmann Maxim S, Feeko Kristofer J, Mojica Jeffrey J

机构信息

Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, 25 S. 9th Street, Philadelphia, PA, 19107, USA.

Department of Anesthesiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.

出版信息

Curr Pain Headache Rep. 2025 Apr 30;29(1):80. doi: 10.1007/s11916-025-01387-y.

Abstract

PURPOSE OF REVIEW

The purpose of this article is to provide a comprehensive review of the ganglia of the head and neck and their role in the interventional management of chronic headaches and facial pain disorders.

RECENT FINDINGS

Interventions targeting the sphenopalatine, stellate and gasserian ganglia are well described in the literature for headaches and facial pain disorders. There is a growing body of evidence supporting use of these techniques for clinical conditions outside of pain such as post-traumatic stress disorder and Long COVID symptoms. These findings increase the potential applications of such procedures, making them more relevant to the interventional physician tasked with managing symptoms in difficult to treat medical conditions. Nerve blocks of the head and neck are used for diagnostic and therapeutic purposes in the management of headaches and facial pain disorders. Headaches, whether acute or chronic, are common pain conditions with a wide-range of etiologies and are often difficult to treat. Chronic facial pain can have a variety of underlying causes, including direct or indirect nerve damage, infection, inflammation, and muscle dysfunction. Traditional pain management strategies such as medications and physical therapy often fail or are associated with significant adverse effects. Interventions such as nerve blocks and neuroablative procedures have shown promise in managing headaches and facial pain by directly targeting the underlying causes. This review article summarizes the most recent evidence regarding the efficacy, safety, applications and limitations of these interventional pain management techniques.

摘要

综述目的

本文旨在全面综述头颈部神经节及其在慢性头痛和面部疼痛疾病介入治疗中的作用。

最新发现

针对蝶腭神经节、星状神经节和半月神经节的干预措施在治疗头痛和面部疼痛疾病方面在文献中有充分描述。越来越多的证据支持将这些技术用于疼痛以外的临床病症,如创伤后应激障碍和新冠后遗症症状。这些发现增加了此类手术的潜在应用范围,使其与负责治疗难治性疾病症状的介入医生更为相关。头颈部神经阻滞在头痛和面部疼痛疾病的管理中用于诊断和治疗目的。头痛,无论是急性还是慢性,都是病因广泛的常见疼痛病症,且往往难以治疗。慢性面部疼痛可能有多种潜在原因,包括直接或间接的神经损伤、感染、炎症和肌肉功能障碍。传统的疼痛管理策略,如药物治疗和物理治疗,往往无效或伴有严重不良反应。神经阻滞和神经毁损术等干预措施通过直接针对潜在病因,在治疗头痛和面部疼痛方面显示出前景。本文综述总结了这些介入性疼痛管理技术在疗效、安全性、应用和局限性方面的最新证据。

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