Clinical evaluation of the developed method effectiveness of anesthesia of the zygomaticofacial nerve

Abstract

The branching of the trigeminal nerve on the face has an individual anatomical variability.  The individual variability of innervation of soft tissues of the maxillofacial area should be taken into account during their local anesthesia. During the blockade of the zygomaticofacial nerve in accordance with the well-known technique, only 74 % of the cases of anesthesia in the buccal and zygomatic areas were completely anesthetized.

The aim of the study – to give a сlinical evaluation of the effectiveness of the developed method of anesthesia of the zygomaticofacial nerve.

Materials and Methods. In the clinical observation  41 stationary  stomatological patients with planned surgical interventions on the lateral facial area took part (in the buccal area – 16 patients, in the zygomatic area – 25 patients).  In order to detect the individual anatomical features of the facial part of the head in patients, the facial index was determined by the Garson`s formula as the relation between the morphological height of the face and its width multiplied by 100. These patients were applied a developed method of conductive anesthesia of the zygomaticofacial nerve and compared its effectiveness with a known method. Pain sensitivity and perception in patients were studied using subjective and objective methods. Pain sensitivity was determined by injection of a needle (pinprick) into the epidermis. Pain perception during local anesthesia administration was evaluated by the Sounds, Eyes and Motor (SEM) scale.

Results and Discussion.  Taking into account the results of craniometric studies as well as the individual topographic and anatomical features of zygomaticofacial nerve branching in people with different types of skull structure, the technique of conduction anesthesia of the branches of the zygomaticofacial nerve was developed. During surgical treatment the effectiveness of the local anesthetic developed method was evaluated as good – it was observed in patients a stable anesthesia, without psychosomatic peculiarities as well as local and general complications.

Conclusions. Application in clinical conditions of the technique of conductive anesthesia of the zygomaticofacial nerve, developed by us, in combination with the classical method of local anesthesia of the buccal nerve provides painless surgical interventions on the lateral area of the face. For the successful local anesthesia of the zygomatic and buccal regions, it is necessary to take into account the anatomical variability of the branch on the face of the zygomaticofacial nerve in patients with different types of skull structure and face shape.