Regional Anesthesia of the Head and Neck

Amsterdam, James T.; Kilgore, Kevin P.

doi:10.1016/b978-1-4160-3623-4.00030-4

Cited by 5 publications

(8 citation statements)

References 5 publications

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“…5 Knowledge of the sensory innervations to the lips and mouth becomes relevant when selecting analgesic approaches for repairing perioral trauma. 7 Vascular Supply to the Perioral Area The face is extremely vascular owing to multiple branches from the external carotid artery: the facial artery, the transverse facial artery, and the maxillary artery. The lips receive arterial blood supply from the facial artery via the inferior and superior labial arteries, which anastomose to encircle the mouth.…”

Section: Sensory Innervationmentioning

confidence: 99%

“…Table 1 describes the techniques to perform infraorbital and mental nerve blocks. 7 Perioral Injury Closure Options Primary closure of perioral wounds should be performed for all clean wounds of the face that present within 24 hours of injury. Delayed primary closure is preferred for contaminated wounds, noncosmetic animal bites, abscess cavities, or wounds with delayed presentation of more than 24 hours.…”

Section: Anesthesia For Lip Laceration Repairmentioning

confidence: 99%

“…Anesthetize the tongue with local infiltration or with lingual nerve block. 7 Suture with 4-0 or 5-0 chromic gut or Vicryl. Place stitches wide and deep.…”

Section: Oral Cavity and Cheek Lacerationsmentioning

confidence: 99%

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Lip and Perioral Trauma

2010

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The management of perioral injuries is a complex topic that must take into consideration the unique anatomy, histology, and function of the lips to best restore form and function of the mouth after injury. Basic reconstructive principles include three-layered closure for full-thickness lip lacerations. Additionally, special care is needed to ensure an aesthetic repair of the cosmetically complex and important vermillion border, philtrum, and Cupid's bow. Infraorbital and mental nerve blocks provide lip anesthesia for laceration repair without distorting crucial aesthetic landmarks. Prophylactic antibiotics are usually indicated in perioral injuries due to wound contamination with saliva. Perioral burn management is controversial; however, most lip burns can first be managed conservatively. Splinting, plasties, and other reconstructive options are available after secondary healing of perioral burns. Hypertrophic scars are common in the perioral area after trauma. The mainstays of treatment for hypertrophic scars on the lips are silicone elastomer sheeting and intralesional steroid injections. For large perioral defects, a myriad of reconstructive options are available, ranging from primary closure, cross-lip flaps, and local tissue transfer, to free tissue transfers such as radial forearm free flaps, innervated gracilis free flaps, anterolateral thigh free flaps, and osteocutaneous free flaps.

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Section: Sensory Innervationmentioning

confidence: 99%

Section: Anesthesia For Lip Laceration Repairmentioning

confidence: 99%

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Lip and Perioral Trauma

2010

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“…Diagnostic and therapeutic supraorbital nerve blocks are used in hemifacial neuralgias and have been systematically performed in various types of headache. Furthermore, supraorbital nerve block is used as an alternative for tissue infiltration in situations such as facial lacerations, forehead and brow lift surgery where tissue distortion would be unacceptable (Amsterdam & Kilgore;Webster et al, 1986).…”

Section: Introductionmentioning

confidence: 99%

“…The peripheral sensory nerves supplying these areas, such as the supraorbital nerve are also considered as putative source of pain. The supraorbital nerve may be affected by swimming goggles or by an anesthetic mask causing neuralgic pain in the forehead (Amsterdam & Kilgore, 2004). …”

Section: Introductionmentioning

confidence: 99%

Supraorbital Notch/Foramen in Sri Lankan Skulls: Morphometry and Surgical Relevance

2014

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SUMMARY:Evidence supports the ethnic and sex variation in the form and position of the supraorbital foramen. Therefore, detailed knowledge of the population specific data on biometric features of the supraorbital foramen will facilitate diagnostic, local anesthetic and surgical manipulations in the maxillo-facial region. The goal of this study was to elucidate the morphological features and precise anatomical position of the supraorbital foramen with reference to surrounding surgically encountered anatomical landmarks in an adult Sri Lankan population. A total of one hundred and eight adult dry skulls of known sex were assessed to determine the number, shape, orientation, vertical and transverse diameters of the supraorbital foramen, transverse distance from the supraorbital foramen to the nasal midline and the zygomatico-maxillary suture and the vertical distance from the supraorbital foramen to the supraorbital rim and infraorbital foramen. The position of the supraorbital foramen was determined in relation to the infraorbital foramen. Data were evaluated between sides and sex. The supraorbital notch (64.81%) was found more frequently than the supraorbital foramen (35.19%). Of the skulls investigated, 55.56% displayed bilateral supraorbital notches, whereas 20.37% had bilateral supraorbital foramina and 24.07% had a notch on one side and a foramen on the contralateral side. The incidence of multiple supraorbital foramina was 6.48%. Sex variations were observed in the relative position of supraorbital notch/foramen from nasal midline (male: 26.12±3.89; female: 24.40±2.76), temporal crest of the frontal bone (male: 32.74±3.94; female: 30.87±4.18) and infraorbital foramen (male: 44.86±3.35; female: 43.26±3.63). The modal position for the infraorbital foramen was lateral to the lateral margin of the supraorbital notch/foramen (68.52%) and supraorbital and infraorbital foramina were lying in the same sagittal plane only in 24.07% of the skulls. The results of this study highlight the racial and sex differences and emphasize the need for meticulous preoperative evaluation of the supraorbital foramen to define the optimal locations in patients who are candidates for maxillo-facial surgeries and regional block anesthesia.

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Efficacy of Local Anesthesia in the Face and Scalp: A Prospective Trial

Safran

Zammit

Kanevsky

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: The use of local anesthesia has allowed for the excision and repair of lesions of the head and neck to be done in an office-based setting. There is a gap of knowledge on how surgeons can improve operative flow related to the onset of action. A prospective trial was undertaken to determine the length of time for full anesthesia effect in the head and neck regions. Methods: Consecutive patients undergoing head and neck cutaneous cancer resection over a 3-month period were enrolled in the study. Local anesthesia injection and lesion excision were all done by a single surgeon. All patients received the standard of care of local anesthesia injection. Results: Overall, 102 patients were included in the prospective trial. The upper face took significantly longer (153.54 seconds) compared with the lower face and ears (69.37 and 60.2 seconds, respectively) ( P < 0.001) to become fully anesthetized. In addition, there was no significant difference found when adjusting for the amount of local anesthesia used, type, and size of lesion ( P > 0.05). Using the time to full anesthesia effect for each local injection, a heat map was generated to show the relative times of the face and scalp to achieve full effect. Conclusions: This prospective trial demonstrated that for the same local anesthetic and concentration, upper forehead and scalp lesions take significantly longer to anesthetize than other lesions in the lower face and ear. This can help surgeons tailor all aspects of their practice, which utilizes local anesthesia to help with patient satisfaction and operative flow.

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Regional Anesthesia of the Head and Neck

Cited by 5 publications

References 5 publications

Lip and Perioral Trauma

Lip and Perioral Trauma

Supraorbital Notch/Foramen in Sri Lankan Skulls: Morphometry and Surgical Relevance

Efficacy of Local Anesthesia in the Face and Scalp: A Prospective Trial

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