Efficacy of Extra-Oral Maxillary Nerve Block Technique Using Frontozygomatic Approach
BACKGROUND Pain control is an integral part of minor oral surgery and maxillary/mandibular nerve blocks have proved promising in achieving the same. Although intra-oral techniques of maxillary nerve block are common and are widely used, there are certain inherent disadvantages and potential complications. Less commonly described in the literature, the extraoral techniques have a wide spectrum of indications as well as can be more advantageous than the intraoral approach [3]. Hence the aim of present study is to evaluate the feasibility and the efficacy of the extra-oral maxillary nerve block using Frontozygomatic approach. MATERIALS AD METHOD The study was conducted on 30 patients reporting to the Department of Oral and Maxillofacial Surgery, V. S. Dental College and Hospital, Bangalore, Karnataka from September 2015 to July 2016 taking into consideration the exclusion and inclusion criteria extraoral maxillary nerve block using frontozygomatic approach was administered. Intraoperative and postoperative complications which may include hematoma, ecchymosis, visual disturbance, limitation of mouth opening or deviation of the lower jaw and Brain Stem Anesthesia immediately following the injections. The data collected was analyzed statistically by using descriptive statistics and percentage; correlations were computed using the student Chi-Square test for proportions. RESULTS Successful anesthesia was secured in a first attempt in 27 patients while in 1 patient, the procedure had to be repeated using local infiltration due to positive aspiration using the Frontozygomatic approach owing to the difficulty in reaching the target site. In 2 patients the stopper over the spinal needle reached the sphenoid bone at 30mm which is 20mm short of the actual penetration of the needle and the reason suspected to be the anatomical variations. A majority of the patients i.e., 53.3 % scored 0–2 (no pain) on visual analog scale (VAS) while 11 patients experienced mild pain and only 3 patients experienced a moderate degree of pain. Subjective symptoms were reported in 22.73 s (mean value) and 18.3 s (mean value) in the palate and the infraorbital fossa respectively. Peak effect of anesthesia was noted in 62.8, 39 and 31.71 sec (all values expressed as mean) in the palate, infraorbital fossa, and posterior superior alveolar areas respectively. CONCLUSION Although with only dental extraction as the procedure of choice, the present study has favored the frontozygomatic angle approach for the maxillary nerve block as simple, safe, efficacious and associated with the minimum and clinically mild complications.
Published by: Dr. Smriti Ticku, Dr. Prashanth .R
Author: Dr. Smriti Ticku
Paper ID: V3I1-1351
Paper Status: published
Published: February 16, 2017
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