The Experts below are selected from a list of 2697 Experts worldwide ranked by ideXlab platform
Antoun Nader - One of the best experts on this subject based on the ideXlab platform.
-
ultrasound guided Maxillary Nerve block via the pterygopalatine fossa Maxillary artery is the key
Regional Anesthesia and Pain Medicine, 2020Co-Authors: Ariana Anugerah, Kim Nguyen, Antoun NaderAbstract:To the Editor We thank Drs Qin and Xie for their interest in our paper, and we agree with their comments that the Maxillary artery is an important landmark when performing the ultrasound-guided Maxillary Nerve block.[1–3][1] However, a high-frequency, small fingerprint ultrasound probe offers
-
technical considerations for approaches to the ultrasound guided Maxillary Nerve block via the pterygopalatine fossa a literature review
Regional Anesthesia and Pain Medicine, 2020Co-Authors: Ariana Anugerah, Kim Nguyen, Antoun NaderAbstract:Background and objectives Blockade of the trigeminal Nerve and its branches is an effective diagnostic tool and potential treatment of facial pain. Ultrasound-guided injections in the pterygopalatine fossa (PPF) to block the trigeminal Nerve divisions and sphenopalatine ganglion have been described but a consensus has yet to be reached over the ideal approach. We sought to delineate and compare the various approaches to the ultrasound-guided trigeminal divisions blockade via the PPF. Methods The literature search was performed by searching the National Library of Medicine’s PubMed database, the Cochrane Database of Systematic Reviews and Google Scholar within the date range of January 2009–March 2019 for keywords targeted toward “trigeminal Nerve,” “Maxillary Nerve,” or “pterygopalatine fossa,” “ultrasound,” and “Nerve block,” using an English language restriction. Six papers were included in the final review: one prospective double-blinded randomized controlled trial, one prospective descriptive study, one case series, two case reports, and one cadaveric study. Results There are three main approaches to the ultrasound-guided trigeminal Nerve branches blockade via the PPF: anterior infrazygomatic in-plane, posterior infrazygomatic in-plane, and suprazygomatic out-of-plane approaches. Each showed injectate spread to the PPF in cadaver, adult and pediatric patients, respectively.1–5 Injectate used varied from 3 to 5 mL to 0.15 mL/kg. Conclusions These studies demonstrated that the PPF is a readily accessible target for the ultrasound-guided Maxillary Nerve block via three main approaches.2 The ideal approach is yet to be determined and must be further explored.
Ariana Anugerah - One of the best experts on this subject based on the ideXlab platform.
-
ultrasound guided Maxillary Nerve block via the pterygopalatine fossa Maxillary artery is the key
Regional Anesthesia and Pain Medicine, 2020Co-Authors: Ariana Anugerah, Kim Nguyen, Antoun NaderAbstract:To the Editor We thank Drs Qin and Xie for their interest in our paper, and we agree with their comments that the Maxillary artery is an important landmark when performing the ultrasound-guided Maxillary Nerve block.[1–3][1] However, a high-frequency, small fingerprint ultrasound probe offers
-
technical considerations for approaches to the ultrasound guided Maxillary Nerve block via the pterygopalatine fossa a literature review
Regional Anesthesia and Pain Medicine, 2020Co-Authors: Ariana Anugerah, Kim Nguyen, Antoun NaderAbstract:Background and objectives Blockade of the trigeminal Nerve and its branches is an effective diagnostic tool and potential treatment of facial pain. Ultrasound-guided injections in the pterygopalatine fossa (PPF) to block the trigeminal Nerve divisions and sphenopalatine ganglion have been described but a consensus has yet to be reached over the ideal approach. We sought to delineate and compare the various approaches to the ultrasound-guided trigeminal divisions blockade via the PPF. Methods The literature search was performed by searching the National Library of Medicine’s PubMed database, the Cochrane Database of Systematic Reviews and Google Scholar within the date range of January 2009–March 2019 for keywords targeted toward “trigeminal Nerve,” “Maxillary Nerve,” or “pterygopalatine fossa,” “ultrasound,” and “Nerve block,” using an English language restriction. Six papers were included in the final review: one prospective double-blinded randomized controlled trial, one prospective descriptive study, one case series, two case reports, and one cadaveric study. Results There are three main approaches to the ultrasound-guided trigeminal Nerve branches blockade via the PPF: anterior infrazygomatic in-plane, posterior infrazygomatic in-plane, and suprazygomatic out-of-plane approaches. Each showed injectate spread to the PPF in cadaver, adult and pediatric patients, respectively.1–5 Injectate used varied from 3 to 5 mL to 0.15 mL/kg. Conclusions These studies demonstrated that the PPF is a readily accessible target for the ultrasound-guided Maxillary Nerve block via three main approaches.2 The ideal approach is yet to be determined and must be further explored.
Ming Yao - One of the best experts on this subject based on the ideXlab platform.
-
Personalized needle modification for CT-guided percutaneous infrazygomatic radiofrequency ablation of the Maxillary Nerve through the foramen rotundum in order to treat V2 trigeminal neuralgia.
Journal of pain research, 2019Co-Authors: Bing Huang, Ming Yao, Keyue Xie, Qianying Liu, Yajing Chen, Yong FeiAbstract:Background: The computed tomography (CT)-guided radiofrequency ablation (RFA) of the Maxillary Nerve (V2) via foramen rotundum (FR) approach has been reported to offer the highest rates of pain relief in V2 trigeminal neuralgia (TN). However, the access to FR may be obstructed by the greater wing of the sphenoid bone. Objectives: We report on an optimized CT-guided percutaneous infrazygomatic of Maxillary Nerve through the foramen rotundum (FR) to treat V2 trigeminal neuralgia (TN) using personalized RFA needles based on patient’s individual CT-image parameters. Patients and methods: 176 patients with isolated V2 TN were included. If the entry of the percutaneous needle into the FR canal was blocked by the greater wing of the sphenoid bone, straight RFA needles was bent at the tip with an angle α (the angle between the straight line from the external opening of FR to the skin entry point and the long axis of the FR canal). The Maxillary Nerve RFA was performed after confirmation with electrophysiological tests. Pain relief in the V2 territory and TN recurrence rate were followed for up to 60 months. Results: Fifty-two patients (29.55%) required needle bending. The Maxillary Nerve thermal RFA resulted in analgesia in the V2 territory without affecting the V1 or V3 zone. TN recurrence rate at 6, 12, 24, 36, 48 and 60 months was 2.55%, 7.64%, 17.20%, 24.41%, 30.28% and 33.77%, respectively. Conclusion: The personalized needle modification technique for Maxillary Nerve RFA through FR is safe and effective to treat V2 TN.
-
The Value and Application of Personalized Needle Modification in Percutaneous Infrazygomatic Radiofrequency in Isolated Maxillary Nerve Pain through the Foramen Rotundum.
Pain physician, 2019Co-Authors: Yajing Chen, Bing Huang, Qianying Liu, Qiang Zhu, Yibing Yao, Chunyan Zhu, Wei Chen, Ming YaoAbstract:BACKGROUND Percutaneous infrazygomatic radiofrequency (PIR) is a common approach used to block isolated Maxillary Nerve (V2) pain through the foramen rotundum (FR) in patients with trigeminal neuralgia (TN). Nevertheless, when using this method, there is a risk of accidental penetration of the superior orbital fissure (SOF) and the optic canal (OC) that may result in the injury of the vessels and Nerves in that area, and in some severe cases may lead to blindness. According to the blocking of the external orifice of the FR and whether a curved needle was used, combined angle deviation from the path of percutaneous infrazygomatic approach, the FR to the SOF or the OC in the treatment of V2 pain, in which no research has reported the angle, we analyzed the value and application of personalized needle modification in PIR in isolated Maxillary Nerve pain through the FR. OBJECTIVES The following study examined the relationship between the FR and the SOF, and analyzed the clinical significance of personalized needle modification in computed tomography (CT)-guided PIR ablation of the Maxillary Nerve through the FR in patients with TN. STUDY DESIGN Randomized, review, clinical research study. SETTING Department of Anesthesiology and Pain Medical Center, Jiaxing, China. METHODS Three-dimensional reconstruction was performed in 88 patients and 136 patients with PIR ablation in isolated Maxillary Nerve pain through the FR. According to the blocking of the external orifice of the FR and whether a curved needle was used, patients were divided into 4 groups: curved-needle blocking group (CB), straight-needle blocking group (SB), straight needle no-blocking group (SN), and curved-needle no-blocking group (CN). RESULTS The results obtained revealed minimum H (shortest diameter of the FR) = 1.0 mm and minimum L (length of the FR tubes) = 3.7 mm. The distance between the external orifice of the FR and the SOF (FS) was 5.16 ± 1.33 mm. The angle A (between the radiofrequency needle and the sagittal plane) was 39 ± 3.95°; the angle between the canthomeatal line and the CT scan line (ACT) was 58.99 ± 6.23°; the puncture depth (LS) was 63.99 ± 4.24 mm; the deviation angle of the misplacement into the SOF (SAF) was 2.96 ± 0.71°; the deviation angle of the misplacement into the OC (OAF) was 4.95 ± 0.73°. In addition, the postoperative Numeric Rating Scale scores in the CB group were significantly lower compared with the SB group, whereas the probability of entering the SOF in the CB group was significantly lower compared with the SB group. The total number of punctures in the SN group was less than that in the CN group. LIMITATIONS Additional clinical data should be collected to preserve the results in future work. CONCLUSIONS The distance between the FR and the SOF or the OC was only few millimeters, and slight angle error could lead to the SOF and the OC. For patients with blockage in the path, the treatment of radiofrequency with personalized needle modification could improve the curative effect and reduce the risk of accidental SOF penetration. KEY WORDS Trigeminal neuralgia, foramen rotundum, superior orbital fissure, radiofrequency, personalized needle modification.
Kim Nguyen - One of the best experts on this subject based on the ideXlab platform.
-
ultrasound guided Maxillary Nerve block via the pterygopalatine fossa Maxillary artery is the key
Regional Anesthesia and Pain Medicine, 2020Co-Authors: Ariana Anugerah, Kim Nguyen, Antoun NaderAbstract:To the Editor We thank Drs Qin and Xie for their interest in our paper, and we agree with their comments that the Maxillary artery is an important landmark when performing the ultrasound-guided Maxillary Nerve block.[1–3][1] However, a high-frequency, small fingerprint ultrasound probe offers
-
technical considerations for approaches to the ultrasound guided Maxillary Nerve block via the pterygopalatine fossa a literature review
Regional Anesthesia and Pain Medicine, 2020Co-Authors: Ariana Anugerah, Kim Nguyen, Antoun NaderAbstract:Background and objectives Blockade of the trigeminal Nerve and its branches is an effective diagnostic tool and potential treatment of facial pain. Ultrasound-guided injections in the pterygopalatine fossa (PPF) to block the trigeminal Nerve divisions and sphenopalatine ganglion have been described but a consensus has yet to be reached over the ideal approach. We sought to delineate and compare the various approaches to the ultrasound-guided trigeminal divisions blockade via the PPF. Methods The literature search was performed by searching the National Library of Medicine’s PubMed database, the Cochrane Database of Systematic Reviews and Google Scholar within the date range of January 2009–March 2019 for keywords targeted toward “trigeminal Nerve,” “Maxillary Nerve,” or “pterygopalatine fossa,” “ultrasound,” and “Nerve block,” using an English language restriction. Six papers were included in the final review: one prospective double-blinded randomized controlled trial, one prospective descriptive study, one case series, two case reports, and one cadaveric study. Results There are three main approaches to the ultrasound-guided trigeminal Nerve branches blockade via the PPF: anterior infrazygomatic in-plane, posterior infrazygomatic in-plane, and suprazygomatic out-of-plane approaches. Each showed injectate spread to the PPF in cadaver, adult and pediatric patients, respectively.1–5 Injectate used varied from 3 to 5 mL to 0.15 mL/kg. Conclusions These studies demonstrated that the PPF is a readily accessible target for the ultrasound-guided Maxillary Nerve block via three main approaches.2 The ideal approach is yet to be determined and must be further explored.
Yajing Chen - One of the best experts on this subject based on the ideXlab platform.
-
Personalized needle modification for CT-guided percutaneous infrazygomatic radiofrequency ablation of the Maxillary Nerve through the foramen rotundum in order to treat V2 trigeminal neuralgia.
Journal of pain research, 2019Co-Authors: Bing Huang, Ming Yao, Keyue Xie, Qianying Liu, Yajing Chen, Yong FeiAbstract:Background: The computed tomography (CT)-guided radiofrequency ablation (RFA) of the Maxillary Nerve (V2) via foramen rotundum (FR) approach has been reported to offer the highest rates of pain relief in V2 trigeminal neuralgia (TN). However, the access to FR may be obstructed by the greater wing of the sphenoid bone. Objectives: We report on an optimized CT-guided percutaneous infrazygomatic of Maxillary Nerve through the foramen rotundum (FR) to treat V2 trigeminal neuralgia (TN) using personalized RFA needles based on patient’s individual CT-image parameters. Patients and methods: 176 patients with isolated V2 TN were included. If the entry of the percutaneous needle into the FR canal was blocked by the greater wing of the sphenoid bone, straight RFA needles was bent at the tip with an angle α (the angle between the straight line from the external opening of FR to the skin entry point and the long axis of the FR canal). The Maxillary Nerve RFA was performed after confirmation with electrophysiological tests. Pain relief in the V2 territory and TN recurrence rate were followed for up to 60 months. Results: Fifty-two patients (29.55%) required needle bending. The Maxillary Nerve thermal RFA resulted in analgesia in the V2 territory without affecting the V1 or V3 zone. TN recurrence rate at 6, 12, 24, 36, 48 and 60 months was 2.55%, 7.64%, 17.20%, 24.41%, 30.28% and 33.77%, respectively. Conclusion: The personalized needle modification technique for Maxillary Nerve RFA through FR is safe and effective to treat V2 TN.
-
The Value and Application of Personalized Needle Modification in Percutaneous Infrazygomatic Radiofrequency in Isolated Maxillary Nerve Pain through the Foramen Rotundum.
Pain physician, 2019Co-Authors: Yajing Chen, Bing Huang, Qianying Liu, Qiang Zhu, Yibing Yao, Chunyan Zhu, Wei Chen, Ming YaoAbstract:BACKGROUND Percutaneous infrazygomatic radiofrequency (PIR) is a common approach used to block isolated Maxillary Nerve (V2) pain through the foramen rotundum (FR) in patients with trigeminal neuralgia (TN). Nevertheless, when using this method, there is a risk of accidental penetration of the superior orbital fissure (SOF) and the optic canal (OC) that may result in the injury of the vessels and Nerves in that area, and in some severe cases may lead to blindness. According to the blocking of the external orifice of the FR and whether a curved needle was used, combined angle deviation from the path of percutaneous infrazygomatic approach, the FR to the SOF or the OC in the treatment of V2 pain, in which no research has reported the angle, we analyzed the value and application of personalized needle modification in PIR in isolated Maxillary Nerve pain through the FR. OBJECTIVES The following study examined the relationship between the FR and the SOF, and analyzed the clinical significance of personalized needle modification in computed tomography (CT)-guided PIR ablation of the Maxillary Nerve through the FR in patients with TN. STUDY DESIGN Randomized, review, clinical research study. SETTING Department of Anesthesiology and Pain Medical Center, Jiaxing, China. METHODS Three-dimensional reconstruction was performed in 88 patients and 136 patients with PIR ablation in isolated Maxillary Nerve pain through the FR. According to the blocking of the external orifice of the FR and whether a curved needle was used, patients were divided into 4 groups: curved-needle blocking group (CB), straight-needle blocking group (SB), straight needle no-blocking group (SN), and curved-needle no-blocking group (CN). RESULTS The results obtained revealed minimum H (shortest diameter of the FR) = 1.0 mm and minimum L (length of the FR tubes) = 3.7 mm. The distance between the external orifice of the FR and the SOF (FS) was 5.16 ± 1.33 mm. The angle A (between the radiofrequency needle and the sagittal plane) was 39 ± 3.95°; the angle between the canthomeatal line and the CT scan line (ACT) was 58.99 ± 6.23°; the puncture depth (LS) was 63.99 ± 4.24 mm; the deviation angle of the misplacement into the SOF (SAF) was 2.96 ± 0.71°; the deviation angle of the misplacement into the OC (OAF) was 4.95 ± 0.73°. In addition, the postoperative Numeric Rating Scale scores in the CB group were significantly lower compared with the SB group, whereas the probability of entering the SOF in the CB group was significantly lower compared with the SB group. The total number of punctures in the SN group was less than that in the CN group. LIMITATIONS Additional clinical data should be collected to preserve the results in future work. CONCLUSIONS The distance between the FR and the SOF or the OC was only few millimeters, and slight angle error could lead to the SOF and the OC. For patients with blockage in the path, the treatment of radiofrequency with personalized needle modification could improve the curative effect and reduce the risk of accidental SOF penetration. KEY WORDS Trigeminal neuralgia, foramen rotundum, superior orbital fissure, radiofrequency, personalized needle modification.
