Background and Objectives Pain resulting from head and neck cancer can be severe and difficult to manage. Avoiding hospitalization for as long as possible with a reasonable level of comfort requires a number of therapeutic modalities. The usefulness of self-administered sphenopalatine ganglion block was evaluated in a patient with lethal midline granuloma requiring large doses of morphine.

Methods A 30-year-old woman with intractable pain from lethal midline granuloma was taught to self-administer 4% lidocaine, 1.5 mL topically into each nostril three times per day.

Results A 3-month follow-up examination showed substantial pain relief and reduction in morphine requirement. No adverse side effects or complications developed.

Conclusions In certain patients, sphenopalatine ganglion block can be effectively self-administered at home to manage chronic pain.