From the Department of Anesthesiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, and.
Department of Anatomy, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Reg Anesth Pain Med. 2018 Oct;43(7):763-767. doi: 10.1097/AAP.0000000000000760.
We aimed to describe a novel technique of ultrasound-guided selective mandibular nerve block with a lateral pterygoid plate (LPP) approach and to assess its feasibility and accuracy in a soft cadaver model.
Ten soft cadavers were studied. A curved array ultrasound transducer was applied over 1 side of the face of the cadaver, in an open-mouth position. The transducer was placed transversely below the zygomatic arch and tilted in the caudal-to-cranial direction to identify the boundary of the LPP. The needle was inserted in-plane, in an anterior-to-posterior direction, into the posterior border of the uppermost part of the LPP, and 3 mL of methylene blue was injected.
Mandibular nerve block was successfully performed in all 10 cadavers using an LPP approach under ultrasound guidance. The mandibular nerve and its branches were seen to be stained with methylene blue in all cadaveric specimens. No accidental injection into the facial nerve or maxillary artery was observed.
This cadaveric study suggests that this novel technique, using an LPP approach under ultrasound guidance, is helpful for selective mandibular nerve block, with high accuracy and feasibility. Further studies are required to establish its safety and efficacy for clinical application.
This study was registered at the Thai Clinical Trials Registry (ClinicalTrials.in.th), identifier TCTR20160601004.
本研究旨在描述一种新的超声引导下经翼外板（LPP）入路选择性下颌神经阻滞技术，并在软尸模型中评估其可行性和准确性。
本研究共纳入 10 具软尸。将曲面探头放置于尸面，在张口位下，于颧骨弓下方横行放置探头，并向头侧倾斜以识别翼外板的边界。将针在矢状面内从前向后插入 LPP 最上部分的后缘，注入 3 mL 亚甲蓝。
在 10 具尸检标本中，均成功地在超声引导下经 LPP 入路行下颌神经阻滞。所有尸检标本中均可见下颌神经及其分支被亚甲蓝染色。未观察到面神经或上颌动脉意外注射。
本尸检研究表明，这种新的超声引导下经 LPP 入路的技术有助于实现选择性下颌神经阻滞，具有较高的准确性和可行性。需要进一步的研究来确定其在临床应用中的安全性和有效性。
本研究在泰国临床试验注册中心（ClinicalTrials.in.th）注册，注册号为 TCTR20160601004。
