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Surgical and Radiologic Anatomy
Published in: Surgical and Radiologic Anatomy 4/2013

01-05-2013 | Original Article

Ultrasound imaging of the infraorbital foramen and simulation of the ultrasound-guided infraorbital nerve block using a skull model

Authors: Pavel Michalek, William Donaldson, Francis McAleavey, Paul Johnston, Rostislav Kiska

Published in: Surgical and Radiologic Anatomy | Issue 4/2013

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Abstract

Purpose

Infraorbital nerve block is used for intraoperative and postoperative analgesia in nasal and oral surgery procedures, as well as in the chronic pain settings. Ultrasound guidance has not been described in the literature. The aim of the study was to assess the quality of ultrasound imaging of the infraorbital foramen and develop an “in-plane” technique of the block using a skull model.

Methods

The infraorbital foramina were assessed on five skull models immersed in the water bath. Ultrasound-guided simulation of an in-plane infraorbital nerve block was then performed. Slightly curved needle was placed close to the foramina and its visibility was recorded. Success rate and time to locate infraorbital foramina, success rate and time to insert the needle close to the foramina under ultrasound and correlation between the ultrasound and caliper measurements were evaluated and recorded. Data for the left and right foramen were compared.

Results

The infraorbital foramina were successfully located using ultrasound in all 20 cases. Simulation of infraorbital nerve block was also successful in all measurements. The time difference between locating or simulating blockade of the left and right infraorbital foramina was not statistically significant. Correlation between ultrasound measurement and direct measurement using a caliper was satisfactory for the distances between the inferior orbital rim and the inferior margin of the infraorbital foramen but poor for the distances between the lower rim of the orbit and the superior margin of the foramen.

Conclusions

This experimental study suggests that the infraorbital foramen is easily located using ultrasound and an “in-plane” ultrasound-guided technique for infraorbital nerve blockade is feasible on the model.
Literature
1.
Agtbong S, Huanmanop T, Chentanez V (2005) Anatomical variations of the supraorbital, infraorbital, and mental foramina related to gender and side. J Oral Maxillofac Surg 64:800–804CrossRef
2.
Berberich G, Reader A, Drum M, Nusstein J, Beck M (2009) A prospective, randomized, double-blind comparison of anesthetic efficacy of two percent lidocaine with 1:100,000 and 1:50,000 epinephrine and three percent mepivacaine in the intraoral, infraorbital nerve block. J Endod 35:1498–1504PubMedCrossRef
3.
Chan BJ, Koushan K, Liszauer A, Martin J (2011) Iatrogenic globe penetration in a case of infraorbital nerve block. Can J Ophtalmol 46:290–291
4.
Clendenen SR, Riutort KT, Finglass NG, Greengrass RA, Brull SJ (2009) Real-time three-dimensional ultrasound for continuous brachial plexus blockade. J Anesth 23:466–468PubMedCrossRef
5.
Deleuze A, Gentili ME, Bonnet F (2009) Regional anaesthesia for head and neck surgery. Ann Fr Anesth Reanim 28:818–823PubMedCrossRef
6.
Friedrich RE, Heiland M, Bartel-Friedrich S (2003) Potential of ultrasound in the diagnosis of midfacial fractures. Clin Oral Investig 7:226–229PubMedCrossRef
7.
Gaonkar V, Daftary SR (2004) Comparison of preoperative infraorbital block with peri-incisional infiltration for postoperative pain relief in cleft lip surgeries. Indian J Plastic Surg 37:105–109
8.
Higashizawa T, Koga Y (2001) Effect of infraorbital nerve block under general anaesthesia on consumption of isoflurane and postoperative pain in endoscopic nasal maxillary sinus surgery. J Anesth 15:136–138PubMedCrossRef
9.
Hu KS, Kwak J, Koh KS, Abe S, Fontaine C, Kim HJ (2007) Topographic area of infraorbital nerve. Surg Radiol Anat 29:383–388PubMedCrossRef
10.
Karkut B, Reader A, Drum M, Nusstein J, Beck M (2010) A comparison of the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block. J Am Dent Assoc 141:185–192PubMed
11.
Kazkayasi M, Ergin A, Ersoy M, Tekdemir I, Elhan A (2003) Microscopic anatomy of the infraorbital canal, nerve, and foramen. Otolaryngol Head Neck Surg 129:692–697PubMedCrossRef
12.
Lee UY, Nam SH, Han SH, Choi KN, Kim TJ (2006) Morphological characteristics of the infraorbital foramen and infraorbital canal using three dimensional models. Surg Radiol Anat 28:115–120PubMedCrossRef
13.
Lynch MT, Syverud SA, Schwab RA, Jenkins JM, Edlich R (1994) Comparison of intraoral and percutaneous approaches for infraorbital nerve block. Acad Emerg Med 1:514–519PubMedCrossRef
14.
Mariano ER, Watson D, Loland VJ, Chu LF, Cheng GS, Mehta SH, Maldonaldo RC, Ilfeld BM (2009) Bilateral infraorbital nerve block decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery. Can J Anaesth 56:584–589PubMedCrossRef
15.
Masuda A, Ito Y (1997) Maxillary bone defect by infraorbital nerve block. J Anesth 11:75–76CrossRef
16.
Mauldin FW Jr, Owen K, Tiouririne M, Hossack JA (2012) The effects of transducer geometry on artifacts common to diagnostic bone imaging with conventional medical ultrasound. IEEE Trans Ultrason Ferroelectr Freq Control 59:1101–1114PubMedCrossRef
17.
Molliex S, Navez M, Baylot D, Prades JM, Elkoury Z, Auboyer C (1995) Regional anaesthesia for outpatient nasal surgery. Br J Anaesth 76:151–153CrossRef
18.
Park JT, Kim YW, Jeong EK, Lee YB (2009) Retrobulbar hematoma after infraorbital nerve block in trigeminal neuralgia. Korean J Pain 22:241–244CrossRef
19.
Saeedi OJ, Wang H, Blomquist PH (2011) Penetrating globe injury during infraorbital nerve block. Arch Otolaryngol Head Neck Surg 137:396–397PubMedCrossRef
20.
Sites BD, Brull R, Chan VW, Spence BC, Gallagher J, Beach ML, Sites VR, Abbas S, Hartman GS (2007) Artifacts and pitfalls errors associated with ultrasound-guided regional anesthesia. Part II: a pictorial approach to understanding and avoidance. Reg Anesth Pain Med 32:419–433PubMed
21.
Tsui BC (2009) Ultrasound imaging to localize foramina for superficial trigeminal nerve block. Can J Anaesth 56:704–706PubMedCrossRef
22.
Turk F, Kurt AB, Saglam S (2010) Evaluation by ultrasound of traumatic rib fractures missed by radiography. Emerg Radiol 17:473–477PubMedCrossRef
Metadata
Title
Ultrasound imaging of the infraorbital foramen and simulation of the ultrasound-guided infraorbital nerve block using a skull model
Authors
Pavel Michalek
William Donaldson
Francis McAleavey
Paul Johnston
Rostislav Kiska
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Surgical and Radiologic Anatomy / Issue 4/2013
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-012-1039-3

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