Document Detail

Anatomic study using three-dimensional computed tomographic scan measurement for truncal maxillary nerve blocks via the suprazygomatic route in infants.
MedLine Citation:
PMID:  19165032     Owner:  NLM     Status:  MEDLINE    
A maxillary nerve block using external anatomic landmarks is a safe regional anesthesia for adults. However, the classic approach to the nerve may be difficult in infants. To use this block in infants, we describe the anatomical landmarks needed to reach the foramen rotundum area using the suprazygomatic route.Computed tomographic scans of 55 infants (mean age, 8.5 months; range, 1 week to 16 months) without any malformation were retrospectively evaluated using multimodal and multiplanar software. For each side, the distances and angles from the skin to the greater wing of the sphenoid and to the foramen rotundum area (representing the maxillary nerve) were measured in the axial and oblique planes.The distances from the skin at the frontozygomatic angle to the greater wing of the sphenoid in the axial plane and the foramen rotundum area in the oblique plane are 24.1 mm +/- 2.7 and 47.4 mm +/- 4.1, respectively. From the skin landmark, the direction of the trajectory was oriented 19.3 +/- 5.3 and 8.7 +/- 2.9 degrees forward. These distances and angles must be slightly adapted for infants younger than 6 months, although none of these parameters were correlated with age during the period studied.This anatomic study based on computed tomographic scan information may be useful for clinical application of the truncal maxillary nerve block in infants using the suprazygomatic route.
Guillaume Captier; Christophe Dadure; Nicolas Leboucq; Magali Sagintaah; Nancy Canaud
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  20     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-23     Completed Date:  2009-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  224-8     Citation Subset:  D    
CHU Montpellier, Unité de Chirurgie Plastique Pédiatrique, Hôpital Lapeyronie, Montpellier, France.
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MeSH Terms
Age Factors
Cephalometry / methods
Cranial Fossa, Middle / radiography
Frontal Bone / radiography
Image Processing, Computer-Assisted / methods
Imaging, Three-Dimensional / methods*
Infant, Newborn
Maxillary Nerve / anatomy & histology*,  radiography
Nerve Block / methods*
Palate / radiography
Retrospective Studies
Sphenoid Bone / radiography
Tomography, X-Ray Computed / methods*
Zygoma / radiography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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