Anatomical landmarks for maxillary nerve block in the pterygopalatine fossa: A radiological study

Carrier, Serge; Castagneyrol, Bastien; Beylacq, L.; Nouette‐Gaulain, Karine; Montaudon, Michel; Laurentjoye, M.

doi:10.1016/j.jormas.2016.12.008

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…This technique differs from the classical blockade by O'Breyn, in which a 40 mm needle is used and the needle moves into the pterygopalatine fossa (sphenopalatine) and the anesthetic is aimed at the pterygopalatine ganglion and V2 nervus trigeminus. It is the reason why this method may be described as atraumatic in comparison to others 24. The safety of infrazygomatic approach has been reported in the study of Kampitak et al showing that the injection point of the anesthetic was the transition from the infratemporal fossa to the pterygopalatine fossa, where the accidental injury of vessels, nerves and the ganglion is minimal 25.…”

Section: Discussionmentioning

confidence: 98%

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Oleshchenko

Çok

Юрьева

et al. 2020

Reg Anesth Pain Med

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BackgroundGeneral anesthesia is required to perform pediatric cataract surgery. To reduce severity of surgical intervention and postoperative complications, regional techniques have been concomitantly used. The traditional regional ophthalmic techniques are retrobulbar, peribulbar and sub-Tenon blocks, which present some technical difficulties and associated complication risks. The pterygopalatine blockade has been exempt of many of these concerns as it is performed out of the orbit. The purpose of this study was to compare the analgesic and anti-inflammatory effects of the pterygopalatine blockade with retrobulbar block in children undergoing elective congenital cataract surgery.MethodsAfter approval of ethics committee and informed consents, patients were enrolled to the study to have either ultrasound-guided pterygopalatine block (group P) or retrobulbar block (group R), with 2 mL lidocaine 2% and 1 mL ropivacaine 0.5%. Hemodynamic monitoring was recorded throughout the perioperative period. Cortisol level and oxidation–reduction status were assessed before and after surgery. Pain and inflammatory response (Tyndall effect, corneal syndrome and edema) were assessed on the first postoperative day.ResultsComparative analysis demonstrated a decrease in cortisol of 123.24% (p˂0.05) and an increase in the redox coefficient of 37.7% (p˂0.05) in group P. Pain intensity was significantly higher in group R until the 16th postoperative hour. The corneal syndrome in patients in group P and group R was noted by 7.6% and in 32.1%, respectively (p˂0.05).ConclusionThe use of the pterygopalatine blockade as a component of anesthesia in pediatric cataract surgery allows reduction of the severity of surgical stress during surgical intervention, providing intraoperative hemodynamic stability and prolonged analgesia.

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Section: Discussionmentioning

confidence: 98%

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Oleshchenko

Çok

Юрьева

et al. 2020

Reg Anesth Pain Med

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“…In the second case, we attempted a novel PNS approach directly to the maxillary nerve next to the external opening of the FR to treat V2 TPHN in the hopes of providing more complete paresthesia coverage of the maxillary region ( Figures 3C,D ). According to the anatomical structure, the maxillary nerve stems from the Gasserian ganglion and passes through the FR ( 34 ). It then divides into several branches, including the ION, the superior alveolar nerve, the zygomatic nerve, and the nerves of the sphenopalatine ganglion.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

Zhao

Song

2021

Front. Neurol.

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Objective: We aimed to report on the use of short-term high cervical spinal cord stimulation (SCS) combined with peripheral nerve stimulation (PNS) to successfully treat trigeminal postherpetic neuralgia (TPHN) affecting the V2 and V3 divisions. We also sought to use a novel PNS approach to the maxillary nerve next to the external opening of the foramen rotundum (FR) to treat TPHN at the V2 division.Method: Two elderly patients successfully treated with different neuromodulation methods for TPHN are presented in this case series.Results: The first case referred to an 83-year-old Chinese female patient with V2 and V3 TPHN who experienced a significant pain relief using a combination of short-term high cervical SCS at the C1–C2 level and PNS on the infraorbital nerve (ION). Case 2 was a 68-year-old Chinese male patient with V1 and V2 TPHN that obtained an excellent pain relief after having received short-term PNS on the supraorbital nerve (SON), the supratrochlear nerve (STN), and the maxillary nerve. Both reported improvements in their quality of life and ability to perform daily tasks during a 3-month follow-up period.Conclusions: Short-term high cervical SCS at the C1–C2 spinal segments may be a feasible method to treat recent-onset V3 TPHN in elderly patients. Additionally, by placing the stimulation lead next to the external FR opening, we demonstrated a novel PNS approach to the maxillary nerve not previously reported for TPHN therapy.

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“…The maxillary nerve exits the skull base through the foramen rotundum and divides into branches to the pterygopalatine ganglion and then across the pterygopalatine fossa. It runs through the infraorbital foramen and terminates into the inferior palpebral, nasal, and superior labial branches [ 34 ]. The maxillary nerve block approaches include the intraoral, infrazygomatic, or suprazygomatic routes [ 34 ].…”

Section: Interventional Treatmentsmentioning

confidence: 99%

“…It runs through the infraorbital foramen and terminates into the inferior palpebral, nasal, and superior labial branches [ 34 ]. The maxillary nerve block approaches include the intraoral, infrazygomatic, or suprazygomatic routes [ 34 ]. In one patient with TN, pulsed radiofrequency (PRF) ablation of the maxillary nerve and subsequent intranasal sphenopalatine ganglion blocks improved pain for 2 years [ 35 ].…”

Section: Interventional Treatmentsmentioning

confidence: 99%

Non-Surgical Treatments of Trigeminal Neuralgia from the Perspective of a Pain Physician: A Narrative Review

Lee,

et al. 2023

Biomedicines

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Trigeminal neuralgia (TN) is a unilateral disorder characterized by electric shock-like pain, abrupt onset and termination, and limited to one or more branches of the trigeminal nerve. Various therapeutic modalities for TN have been introduced. We searched for literature indexed in PubMed, Medline, and the National Library of Medicine and reviewed all relevant articles on non-surgical treatments for TN. Published studies were reviewed with no restrictions on date; reviews, clinical trials, animal studies, retrospective studies, and cases were included. Carbamazepine and oxcarbazepine are the recommended first-line pharmacotherapies. Interventional treatments should be considered when pharmacotherapy is insufficient or withdrawn because of adverse effects.

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Anatomical landmarks for maxillary nerve block in the pterygopalatine fossa: A radiological study

Cited by 3 publications

References 24 publications

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

Non-Surgical Treatments of Trigeminal Neuralgia from the Perspective of a Pain Physician: A Narrative Review

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