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Original article
peer-reviewed

Cadaveric Study for Intraoral Needle Access to the Infratemporal Fossa: Application to Posterior Superior Alveolar Nerve Block Technique



Abstract

The posterior superior alveolar (PSA) nerve block is, from an anatomical perspective, challenging because the mandibular ramus and the zygomatic process of the maxilla can interfere with the course of the needle. Dentists empirically know that shifting the patient’s mandible to the ipsilateral side can improve visibility and accessibility for such blocks. This cadaveric study aimed to establish anatomical evidence for the ipsilateral mandible shifting used in the PSA. The distance between the lateral most bulging point of the alveolar part of the maxilla and ipsilateral anterior border of the ramus of the mandible ranged from 1.4 to 6.9 mm with a mean of 4.3 ± 1.6 mm. This result supports the empirical technique of shifting the mandible ipsilaterally for PSA nerve block.



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Original article
peer-reviewed

Cadaveric Study for Intraoral Needle Access to the Infratemporal Fossa: Application to Posterior Superior Alveolar Nerve Block Technique


Author Information

Joe Iwanaga

Seattle Science Foundation

Emily Simonds Corresponding Author

Seattle Science Foundation

Rod J. Oskouian

Swedish Neuroscience Institute

R. Shane Tubbs

Neurosurgery, Seattle Science Foundation


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Seattle Science Foundation issued approval. This study used human cadaveric specimens. The present study protocol did not require approval by the ethics committees of our institutions and the work was performed in accordance with the requirements of the Declaration of Helsinki (64th World Medical Association General Assembly, Fortaleza, Brazil, October 2013). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

The authors wish to thank all those who donated the cadavers for the advancement of education and research


Original article
peer-reviewed

Cadaveric Study for Intraoral Needle Access to the Infratemporal Fossa: Application to Posterior Superior Alveolar Nerve Block Technique


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Original article
peer-reviewed

Cadaveric Study for Intraoral Needle Access to the Infratemporal Fossa: Application to Posterior Superior Alveolar Nerve Block Technique

Joe Iwanaga">Joe Iwanaga, Emily Simonds">Emily Simonds , Rod J. Oskouian">Rod J. Oskouian, R. Shane Tubbs">R. Shane Tubbs

  • Author Information
    Joe Iwanaga

    Seattle Science Foundation

    Emily Simonds Corresponding Author

    Seattle Science Foundation

    Rod J. Oskouian

    Swedish Neuroscience Institute

    R. Shane Tubbs

    Neurosurgery, Seattle Science Foundation


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Seattle Science Foundation issued approval. This study used human cadaveric specimens. The present study protocol did not require approval by the ethics committees of our institutions and the work was performed in accordance with the requirements of the Declaration of Helsinki (64th World Medical Association General Assembly, Fortaleza, Brazil, October 2013). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    The authors wish to thank all those who donated the cadavers for the advancement of education and research


    Article Information

    Published: October 09, 2017

    DOI

    10.7759/cureus.1761

    Cite this article as:

    Iwanaga J, Simonds E, Oskouian R J, et al. (October 09, 2017) Cadaveric Study for Intraoral Needle Access to the Infratemporal Fossa: Application to Posterior Superior Alveolar Nerve Block Technique. Cureus 9(10): e1761. doi:10.7759/cureus.1761

    Publication history

    Received by Cureus: September 18, 2017
    Peer review began: October 03, 2017
    Peer review concluded: October 04, 2017
    Published: October 09, 2017

    Copyright

    © Copyright 2017
    Iwanaga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The posterior superior alveolar (PSA) nerve block is, from an anatomical perspective, challenging because the mandibular ramus and the zygomatic process of the maxilla can interfere with the course of the needle. Dentists empirically know that shifting the patient’s mandible to the ipsilateral side can improve visibility and accessibility for such blocks. This cadaveric study aimed to establish anatomical evidence for the ipsilateral mandible shifting used in the PSA. The distance between the lateral most bulging point of the alveolar part of the maxilla and ipsilateral anterior border of the ramus of the mandible ranged from 1.4 to 6.9 mm with a mean of 4.3 ± 1.6 mm. This result supports the empirical technique of shifting the mandible ipsilaterally for PSA nerve block.



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Joe Iwanaga, Ph.D., Assistant Professor

Seattle Science Foundation

Emily Simonds

Seattle Science Foundation

For correspondence:
easimonds@gmail.com

Rod J. Oskouian, M.D.

Swedish Neuroscience Institute

R. Shane Tubbs, Ph.D., Professor

Neurosurgery, Seattle Science Foundation

Joe Iwanaga, Ph.D., Assistant Professor

Seattle Science Foundation

Emily Simonds

Seattle Science Foundation

For correspondence:
easimonds@gmail.com

Rod J. Oskouian, M.D.

Swedish Neuroscience Institute

R. Shane Tubbs, Ph.D., Professor

Neurosurgery, Seattle Science Foundation