PONOS CLINIC · SPG PATHWAY
The role of CT in assessing the sphenopalatine ganglion
When imaging adds useful information for planning a possible percutaneous approach.
When CT may be useful
When a percutaneous approach to the sphenopalatine ganglion is being considered, CT of the facial bones or skull base can help assess individual anatomy, identify relevant variants and evaluate the access route.
Clinical indication comes before imaging
The request depends on the planned procedure and the imaging already available. It is not automatic for every patient with headache or before every transmucosal block. The indication must be defined within the SPG pathway.
What CT assesses
- the shape of the pterygopalatine fossa
- relationships with nearby bones and paranasal cavities
- possible asymmetries or anatomical variants
- possible anatomical obstacles along the access route
Multiplanar reconstructions help assess the anatomy. A non-contrast CT does not provide a complete map of blood vessels; further imaging and contrast use depend on the clinical question agreed with the radiologist.
CT and patient selection
In some cases, CT can help assess technical feasibility, suggest greater caution or lead to a decision to defer the procedure if the risk is unacceptable.
Before booking
Bring complete reports and images from previous examinations, preferably in DICOM format. The radiology service defines the protocol and any contrast use. Tell the service if pregnancy is possible; if contrast is planned, report previous reactions and kidney problems and follow the centre’s instructions.
The PONOS pathway
- Clinical assessment and definition of the question.
- Review of existing imaging.
- CT when useful for anatomical planning.
- Shared decision about the approach and procedure.
CT adds anatomical information; it does not replace clinical diagnosis or make a procedure automatic.
Frequently asked questions
Is CT needed before every SPG block?
No. The need depends on the planned procedure and clinical question.
Does a normal CT exclude SPG involvement?
No. CT mainly describes anatomy and does not establish the source of pain on its own.
Does CT predict the result of radiofrequency?
No. Anatomical feasibility and clinical effectiveness are separate issues.
Assess before intervening
Bring the available documentation so we can identify which information is genuinely useful for your pathway.
References: ACR/RSNA RadiologyInfo: CT of the sinuses; Ho et al., systematic review of SPG treatments.
General information: this does not replace specialist assessment or establish an indication for an examination or treatment on its own.