Background The prevalence of suprascapular neuropathy is higher than previously estimated. Recent literature highlights a myriad of treatment options for patients ranging from conservative treatment and minimally invasive options to surgical management. However, there are no comprehensive review articles comparing these treatment modalities. Objective The purpose of this review article is to summarize the current state of knowledge on suprascapular nerve entrapment and to compare minimally invasive treatments to surgical treatments. Methods The literature search was performed in Mendeley. Search fields were varied redundant. All articles were screened by title and abstract and a preliminary decision to include an article was made. A full-text screening was performed on the selected articles. Any question regarding the inclusion of an article was discussed by 3 authors until an agreement was reached. Results Recent studies have further elucidated the pathoanatomy and described several risk factors for entrapment ranging. Four studies met our inclusion criteria regarding peripheral nerve stimulation with good pain and clinical outcomes. Two studies met our inclusion criteria regarding pulsed radiofrequency and showed promising pain and clinical outcomes. One study met our inclusion criteria regarding transcutaneous electrical nerve stimulation and showed good results that were equivalent to pulsed radiofrequency. Surgical treatment has shifted to become nearly all arthroscopic and surgical outcomes remain higher than minimally invasive treatments. Conclusions Many recently elucidated anatomical factors predispose to entrapment. A history of overhead sports or known rotator cuff disease can heighten a clinician’s suspicion. Entrapment at the suprascapular notch is more common overall, yet young athletes may be predisposed to isolated spinoglenoid notch entrapment. Pulsed radiofrequency, peripheral nerve stimulation, and transcutaneous electrical nerve stimulation may be effective in treating patients with suprascapular nerve entrapment. Arthroscopic treatment remains the gold-standard in patients with refractory entrapment symptoms.
<p class="abstract">This report intends to summarize the underlying pathophysiology, relevant symptoms, appropriate diagnostic workup, necessary imaging, and medical and surgical treatments of Sphenopalatine neuralgia (SN). This was done through a comprehensive literature review of peer-reviewed literature throughout the most relevant databases. Dr. Greenfield Sluder first observed that a number of his patients had atypical headaches that caused referred pain to the head and neck regions. The current understanding of the pathophysiology of SN states that irritation of the pterygopalatine ganglion secondary to inflammatory processes of the posterior ethmoid and sphenoid sinuses causes symptoms including unilateral persistent headache that begins lateral to the nose or near the eye and radiates across the face. Diagnosis is typically clinical; however, this is challenging due to lack of a definitive diagnostic criteria. Dr. Sluder originally treated his patients with 20-67% cocaine that was injected into the pterygopalatine ganglion to relieve the pain. Today, we use 88% phenol applied to the nasal mucosa. The most definitive way to both diagnoses and treat SN is the injection of cocaine or 88% phenol into the sphenopalatine region. The aim of the study was to update providers on the important clinical signs of SN and the important distinction between the clinically distinct conditions of sphenopalatine neuralgia and cluster headache. This report also outlines the treatment options to address this condition. </p>
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