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At least 19 recordsLinked to original sources
PubMed1998

Truncal anaesthesia of the maxillary nerve for outpatient surgically assisted rapid maxillary expansion.

We present our experience of transcutaneous truncal anaesthesia of the maxillary nerve in association with transmucosal anaesthesia of the sphenopalatine ganglion in surgically assisted rapid maxillary expansion. Twelve patients with a skeletal transverse discrepancy of the maxilla were treated in our department from 1994 to 1995. Maxillary transcutaneous nerve block was done with a Quincke 8 cm spinal needle together with transmucosal anaesthesia of the sphenopalatine ganglion. Mepivacaine without adrenaline and sodium bicarbonate 1/10 was used for truncal anaesthesia and lidocaine-prilocaine cream for transmucosal anaesthesia. A Le Fort I osteotomy, lateral nasal wall osteotomy, pterygomaxillary osteotomy, and a palatal osteotomy were done for all patients before the maxillary expansion. Total anaesthesia of the maxillary area facilitated the operations and appreciably reduced the amount of postoperative pain. The ease of achieving effective anaesthesia before and after operation and the absence of side-effects make this form of anaesthetic particularly useful in surgically assisted rapid maxillary expansion.

Adolescent↗
PubMed2002

A new method of continuous maxillary nerve block with an indwelling catheter.

OBJECTIVE: We describe continuous maxillary nerve block at the pterygopalatine fossa and investigate the efficacy of this technique for perioperative pain control in oral surgery. STUDY DESIGN: Sixteen patients undergoing radical maxillary sinusotomy were enrolled; group I (n = 8) received general anesthesia without maxillary nerve block, and group II (n = 8) received maxillary nerve block before general anesthesia. The intraoperative concentration of sevoflurane, the extent of blockade, and total analgesics (diclofenac sodium) needed after surgery were recorded. RESULTS: The mean sevoflurane concentration was significantly lower in group II. Diclofenac sodium consumption was significantly reduced in group II. CONCLUSION: Indwelling maxillary nerve catheter methods decrease anesthetic consumption and provide good postoperative analgesia.

Adult↗
PubMed1997

Pterygopalatine fossa and maxillary nerve infiltration in nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma (NPC) may infiltrate the pterygopalatine fossa (PPF) and the maxillary nerve. This study illustrates involvement of the maxillary nerve in the PPF with perineural spread to the cavernous sinus. METHODS: One hundred and fourteen patients with proven NPC were studied using magnetic resonance imaging (MRI) and computed tomography (CT). The images were retrospectively reviewed for PPF infiltration and maxillary nerve involvement. RESULTS: Seventeen (15%) patients showed infiltration of the PPF. Four patients had maxillary nerve involvement and a perineural spread to the cavernous sinus. Of the 17 patients with PPF infiltration, 8 (47%) patients showed hypoesthesia in the distribution of the infraorbital nerve. All 4 patients with contrast-enhancement of the maxillary nerve exhibited infraorbital neuropathy. CONCLUSION: Infiltration of the maxillary nerve in the PPF with intracranial spread is uncommon but should be suspected in patients with infraorbital neuropathy. This is important as it affects both prognosis and radiation treatment planning.

Cranial Nerve Neoplasms↗
PubMedDate not supplied

Use of computed tomography for maxillary nerve block in the treatment of trigeminal neuralgia.

BACKGROUND AND OBJECTIVES: Maxillary nerve block has traditionally been performed by using external anatomic landmarks. However, the classic approach to the nerve may be confounded because of anatomic variability. We describe a technique for the block using the suprazygomatic route guided by computed tomography (CT). CASE REPORT: A 90-year-old woman had a 30-year history of episodic pain in her right maxillary region. We attempted to block the maxillary nerve with classic technique, but we could not identify the nerve by eliciting paresthesia. In addition, bleeding was noted after repeated attempts. To minimize complications and confirm the correct position of the needle tip, we planned the block with a suprazygomatic approach using CT guidance. The needle was inserted without paresthesia. The CT scan showed the needle tip was placed at the entrance of the pterygopalatine fossa and the distribution of contrast medium spread appropriately around the pterygopalatine fossa. After confirming the clinical effect and lack of complications of the block using the local anesthetic, 0.5 mL of 7% phenol was injected. This technique resulted in complete sensory loss in the area innervated by the maxillary nerve, and did so without complications. CONCLUSIONS: A maxillary nerve block guided by a CT imaging is an alternative to classic techniques.

Aged↗
PubMed1993

Neurotrophins and their receptors in rat peripheral trigeminal system during maxillary nerve growth.

We examined the expression of the neurotrophins (NTFs) and their receptor mRNAs in the rat trigeminal ganglion and the first branchial arch before and at the time of maxillary nerve growth. The maxillary nerve appears first at embryonic day (E)10 and reaches the epithelium of the first branchial arch at E12, as revealed by anti-L1 immunohistochemistry. In situ hybridization demonstrates, that at E10-E11, neurotrophin-3 (NT-3) mRNA is expressed mainly in the mesenchyme, but neurotrophin-4 (NT-4) mRNA in the epithelium of the first branchial arch. NGF and brain-derived neurotrophic factor (BDNF) mRNAs start to be expressed in the distal part of the first brachial arch shortly before its innervation by the maxillary nerve. Trigeminal ganglia strongly express the mRNA of trkA at E10 and thereafter. The expression of mRNAs for low-affinity neurotrophin receptor (LANR), trkB, and trkC in trigeminal ganglia is weak at E10, but increases by E11-E12. NT-3, NT-4, and more prominently BDNF, induce neurite outgrowth from explant cultures of the E10 trigeminal ganglia but no neurites are induced by NGF, despite the expression of trkA. By E12, the neuritogenic potency of NGF also appears. The expression of NT-3 and NT-4 and their receptors in the trigeminal system prior to target field innervation suggests that these NTFs have also other functions than being the target-derived trophic factors.

Animals↗
PubMedDate not supplied

Anatomic considerations in relation to the maxillary nerve block.

BACKGROUND AND OBJECTIVES: To determine the length of the needle that should be used to reach the maxillary nerve after the lateral pterygoid plate has been contacted. METHODS: The study was conducted on patients and skulls. Patient study: The distances from skin at the midpoint of lower border of zygomatic arch to lateral pterygoid plate and to the point where a paresthesia in the distribution of maxillary nerve was obtained were measured in 75 patients. Osteologic study: The distance from the midpoint of lower border of zygomatic arch to lateral pterygoid plate and to a probe inserted from the orbital aspect through the inferior orbital fissure and pterygopalatine fossa into the foramen rotundum (representing maxillary nerve) was measured in 120 skulls. RESULTS: Patient study: The distance to the point where paraesthesia occurred was more than that to the lateral pterygoid plate by 0.21 cm on the right side and 0.22 cm on the left side. Osteologic study: The distance to the probe in the pterygopalatine fossa was more than the distance to lateral pterygoid plate by 0.13 cm on the right side and 0.14 cm on the left side. CONCLUSIONS: The needle should not be advanced by more than approximately 0.25 cm beyond the distance to the pterygoid plate while performing maxillary nerve block by the lateral extraoral approach.

Adult↗
PubMedDate not supplied

[Percutaneous maxillary nerve block anesthesia in maxillofacial surgery].

BACKGROUND: Personal experience in percutaneous maxillary nerve block anesthesia in association with transmucosal anesthesia of the sphenopalatine ganglion in oral and maxillofacial surgery, is presented. METHODS: Six Caldwell-Luc, 9 anthrotomies and biopsies of maxillary sinus, 8 removals of extensive odontogenic cysts and 12 surgical maxillary expansions were performed from 1994 to 1996 at our Department. Maxillary transcutaneous nerve block in association with transmucosal anesthesia of the sphenopalatine ganglion were performed. Carbocaine without adrenaline in association with NaCO3 1/10 for maxillary nerve block anesthesia and lidocaineoprilocaine cream (EMLA) for transmucosal anesthesia were employed. Intra- and post-operative pain were evaluated by visual analogue scale in all the patients. RESULTS: Anesthesiological procedures revealed to be effective in all surgical interventions and postoperative analgesia allowed easier pain control. CONCLUSIONS: The simplicity of execution, the effective pre- and postoperative anesthesia and the absence of side effects make this procedure particularly indicated in oral and maxillofacial surgery.

Anesthesia, Dental↗
PubMed1995

Dissemination of wild-type and gC-, gE-and gI-deleted mutants of Aujeszky's disease virus in the maxillary nerve and trigeminal ganglion of pigs after intranasal inoculation.

Aujeszky's disease virus (ADV) is a well known neurotropic virus in pigs. In the present study the mechanism of spread of ADV along the maxillary nerve and the role of the viral envelope glycoproteins gC, gE and gI in this process was examined in pigs. The Ka parental strain of ADV and its gC-, gE- and gI-deleted mutants were inoculated intranasally in pigs, after which virus dissemination in the maxillary nerve and the trigeminal ganglion was monitored at time intervals by means of virus isolation. The parental strain was isolated from both the nasal mucosa and the trigeminal ganglion at 21 h post-inoculation (p.i.), whereas the middle part of the connecting maxillary nerve was positive only after 48 h p.i. It appears, therefore, that ADV travels from the nasal mucosa via the nerve towards the ganglion in a non-infectious form, and then replicates in the neuronal somas, after which infectious virus is transported towards the nasal mucosa. Although all mutants were present at 48 h p.i. in the nasal mucosa and the trigeminal ganglion, the appearance of infectious virus in the maxillary nerve was clearly delayed with gE- and gI- mutants. It is suggested that glycoproteins gE and gI are involved in the axonal transport of infectious ADV away from neuronal cell bodies, also called anterograde transport.

Animals↗
PubMed1991

Maxillary nerve block anaesthesia via the greater palatine canal: a modified technique and case reports.

A modification of the technique of maxillary nerve block (via the greater palatine canal) is discussed. This technique has been employed in the Exodontia and Oral Surgery Clinics of the United Dental Hospital of Sydney for more than 40 years. Clinical experience in that time has shown that once the greater palatine canal has been negotiated successfully, the palatal canal approach to the maxillary nerve is safe and reliable. The value of being able to anaesthetize the maxillary nerve and its branches is illustrated by the presentation of two clinical cases where local anaesthesia was achieved and the extractions performed in patients who would otherwise have required a general anaesthetic for the procedures.

Adult↗
PubMed1985

Maxillary nerve involvement in bacterial endocarditis.

A case of right maxillary nerve paresthesia during an active phase of bacterial endocarditis probably due to embolic occlusion of the nerve's vascular supply is reported. The authors suggest that infective endocarditis be considered as a rare but potential cause of unexplained trigeminal nerve branch lesions, and that such lesions be sought in cases of established endocarditis.

Embolism↗
PubMed1995

Maxillary nerve block: a case report and review of the intraoral technique.

Maxillary nerve blockade is not commonly used by general practitioners due to a lack of experience with the techniques involved and the fear of iatrogenic damage. Nevertheless, it represents an excellent method of producing profound anesthesia in the maxilla, with definite indications in selected instances. The anatomy and techniques associated with the maxillary block, as well as the indications, contraindications and complications are reviewed, and the use of the greater palatine foramen approach to treat a patient with a facial abscess is described.

Anesthesia, Dental↗
PubMed1990

[Effect of histamine on the action potential of the maxillary nerve in rabbits].

The significant enhancement of action potential as recorded from rabbit maxillary nerve with topically applied 1.0 mmol/L histamine on the nasal mucosa was completely blocked by pretreatment with diphenhydramine (H1 antagonist) but not with cimetidine (H2 antagonist). This fact gives new support to the concept that histamine exerts its pathological effect on nasal mucosa at least partly via an afferent nervous pathway of the trigeminal nerve.

Action Potentials↗
PubMed1994

Choristoma of the intracranial maxillary nerve in a child. Case report.

This report describes what the authors believe to be the first reported case of choristoma of the intracranial maxillary nerve. This 12-year-old girl presented with a 5-year history of severe isolated left-sided trigeminal neuralgia. Computerized tomography and magnetic resonance imaging revealed a mass below the anterior portion of the left cavernous sinus, enlarging the foramen rotundum. Total resection was achieved via a pterional extradural approach. Histological examination revealed a choristoma composed of smooth-muscle fibers. The histogenesis of these tumors when they develop in a nerve remains unclear. They may represent abnormal migration or proliferation of neuroectodermal tissue in or close to a peripheral nerve. Total removal of these tumors should be attempted at initial diagnosis.

Actin Cytoskeleton↗
PubMed1993

Maxillary nerve block via the greater palatine canal: new look at an old technique.

Although not widely used, maxillary nerve block via the greater palatine canal can be remarkably effective. This article is aimed at reviving its use by reviewing the indications, contraindications, and anatomy of the technique. A simplified guide to the technique is offered to place the technique within the armamentarium of the practicing dentist.

Anesthesia, Dental↗
PubMed1980

Fibers of trigeminal mesencephalic neurons in the maxillary nerve of the rat.

Indirect Wallerian degeneration after sectioning the infraorbital nerve, and retrograde axonal transport following injection of horseradish peroxidase (HRP) into the maxillary nerve were studied in rats. These experiments showed the existence of primary trigeminal neurons in the pars caudalis of the ipsilateral trigeminal mesencephalic nucleus and in the supratrigeminal nucleus of Lorente de Nó. Such neurons were interpreted as being responsible for the sensitive innervation of the periodontal membrane.

Animals↗