Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.
Humans ; Mandibular Nerve ; Maxillary Nerve ; Maxillary Sinus ; Ophthalmic Nerve ; Pro-Opiomelanocortin ; Trigeminal Nerve ; Trigeminal Nerve Diseases ; Trigeminal Neuralgia*

As an important landmark, the posterolateral wall of maxillary sinus can help to locate numbers of significant signs such as maxillary artery and its branches, maxillary nerve and infraorbital nerve, infratemporal fossa and pterygopalatine fossa etc. in the endoscopic surgery for paranasal sinuses and lateral skull base. This article reviewed related researches about the anatomy and endoscopic surgery of posterolateral wall of maxillary sinus.
Endoscopy ; Humans ; Maxillary Artery ; Maxillary Nerve ; Maxillary Sinus ; anatomy & histology ; Nasal Surgical Procedures ; Pterygopalatine Fossa

The present case report describes a complication involving facial blanching symptoms occurring during inferior alveolar nerve block anesthesia (IANBA). Facial blanching after IANBA can be caused by the injection of an anesthetic into the maxillary artery area, affecting the infraorbital artery.
Anesthesia* ; Anesthesia, Dental ; Arteries ; Mandibular Nerve* ; Maxillary Artery ; Nerve Block

OBJECTIVETo observe the travel, divisions, and the lengths, diameters, branches, artery supplies of the main segments of maxillary nerve.

METHODSFifty formalin-preserved adult half-head specimens with intravascular injection of red color emulsion were used for the gross and microanatomical studies of maxillary nerve. The lengths, diameters, branches and artery supplies of four main segments of maxillary nerve were observed. SPSS 11.5 software was used to analyze the data.

RESULTSThe length and diameter of cranial middle fossa segment of maxillary nerve were (10.70 ± 1.31) mm and (4.01 ± 0.52) mm respectively, which was supplied by inferior-lateral cavernous sinus artery. The length and diameter of pterygopalatine fossa segment were (16.21 ± 1.80) mm and (3.27 ± 0.62) mm respectively, in which one zygomatic branch, one to three posterior superior alveolar nerves, two ganglion branches and tuberal descending branches; were given off, and the segment was supplied by foramen rotundum artery. The length and diameter of infraorbital segment were (25.73 ± 2.03) mm and (3.30 ± 0.52) mm and it gave off middle superior alveolar nerve (64%) and anterior superior alveolar nerve and was supplied by infraorbital artery. Facial segment gave off superior labial branches, internal and external nasal branches, inferior palpebral branches, buccal branch and zygomatic branch and these branches were supplied by infraorbital artery and superior labial and angular artery originating from facial artery.

CONCLUSIONSUnderstanding of travel and artery supply of maxillary nerve is helpful to regional anaesthesia and surgery for maxillary nerve. Foramen rotundum, sphenopalatine foramen and infraorbital nerve are important marks for endoscopic surgery in pterygopalatine fossa.

Biplane fluoroscopy is usually used in angiography. Biplane fluoroscopy gives a biplane image with high resolution during the performance of operations. Trigeminal nerve blocks are effective treatment modalities for trigeminal neuralgia, and maxillary nerve block is the most dangerous procedure among them. The anatomic structures can change after head and neck surgery, so the trigeminal nerve block procedures cannot be done so easily. We used biplane fluoroscopy in these difficult cases. Our first case was a 60-year-old man who had undergone maxillary nerve block. The second case was of a 64-year-old man who had pulsed radiofrequency lesioning of mandibular nerve performed after head and neck surgery. With biplane fluoroscopy, we got good results without any complications.
Angiography ; Fluoroscopy* ; Head ; Humans ; Mandibular Nerve* ; Maxillary Nerve* ; Middle Aged ; Neck ; Trigeminal Nerve ; Trigeminal Neuralgia

Patients of infraorbital nerve injury often appear in the sensory abnormalities of corresponding position, such as numbness or pain. We present a case with numbness of the left cheek because of the injury. The patient were treated by endoscopic assisted on the left infraorbital nerve decompression through the approach of the canine fossa. The symptom shows improvement after the operation. The patient feels numbness significantly ease on 4 months after the operation.
Decompression, Surgical ; Endoscopy ; Humans ; Maxillary Nerve ; physiopathology ; surgery ; Paresthesia

OBJECTIVE: To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection. METHODS: Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication. RESULTS: During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed. CONCLUSIONS Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.
Facial Nerve ; Humans ; Lip ; Maxilla ; Maxillary Neoplasms ; Surgical Flaps

BACKGROUND: Recently trigeminal nerve block with alcohol (TnbA) for the treatment of trigeminal neuralgia (TN) has come to be known as a procedure with a short-term effect and high complications. There has been none of report about long-term outcome of TnbA for TN. The objective of this prospective study for the long-term results of TnbA was to analyse the pain free duration and complication after the administration of blocks and compare them in the first block and subsequent blocks. METHODS: From March 1996 to May 2005, 304 consecutive patients with primary trigeminal neuralgia were treated with TnbA including supraorbital nerve block, infraorbital nerve block, maxillary nerve (V2) block, mandibular nerve (V3) block, and V2 and V3 at the same time and were prospectively followed up every two months for 10 years. RESULTS: The mean value of pain free duation of 1st, 2nd and 3rd TnbA were 43, 38 and 48 months, respectively using Kaplan-Meier analysis. The probability of pain recurrence in 1 and 3 years after the 1st, 2nd and 3rd blocks were 25%, 25%, 20% and 53%, 54%, 34%, respectively. The pain free durations of first and subsequent blocks were not statistically different. Complications were reported at 36 (11.8%), 5 (4.2%), and 0 in 1st, 2nd and 3rd blocks. CONCLUSIONS: TnbA showed the relatively long duration of pain free and low incidence of complications. Repeated TnbA has pain free duration as long as the 1st block and less complications as well. TnbA is a valuable treatment of TN as a percutaneous procedure.
Humans ; Incidence ; Kaplan-Meier Estimate ; Mandibular Nerve ; Maxillary Nerve ; Nerve Block ; Prospective Studies ; Recurrence ; Trigeminal Nerve* ; Trigeminal Neuralgia*

The purpose of this study was to investigate the courses of the maxillary artery and variations of the arteries and nerves in the infratemporal fossa from 36 Korean adult cadavers. The results were as follows; 1. In the majority of the cases (81.9%), course of the maxillary artery runs lateral to the lateral pterygoid muscle. 2. The variations of the arteries and nerves in the infratemporal fossa could be classified into six types. In the most common (type 2, 61.1%), the maxillary artery runs lateral to the lateral pterygoid muscle, and the inferior alveolar lingual and buccal nerves lie medial to the maxillary artery. In the next (type 1, 20.8%), the maxillary artery runs lateral to the lateral pterygoid muscle and the inferior alveolar and lingual nerves lie medial to the maxillary artery, and buccal nerve lies lateral to the maxillary artery. The remaining types were type 3 (7.0%), type 4 (4.2%), type 5 (5.6%) and type 6 (1.4%) in order.
Adult ; Arteries* ; Cadaver ; Humans ; Lingual Nerve ; Mandibular Nerve ; Maxillary Artery ; Pterygoid Muscles

OBJECTIVES: The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided. METHODS: A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups. Then, 219 patients with permanent dentition were divided into an adolescent group (13-18 years old) and adult group (over 19 years old), all of whom underwent bilateral greater palatine nerve block. Palatal mucosal pain sensation was tested pre- and post-anesthesia with Von Frey hairs. RESULTS: Among the children with mixed dentition, bilateral greater palatine nerve block tended to result in better anesthetic effects than nasopalatine nerve block ( CONCLUSIONS The sensation of the anterior hard palatine seems mainly dominated by the greater palatine nerve until mixed dentition and gradually shifted to the nasopalatine nerve in conjunction with maxillary development and tooth replacement. Hence, the innervation of the anterior hard palatine induce a secondary development during the development of the maxilla.
Adolescent ; Adult ; Child ; Dentition, Mixed ; Humans ; Maxilla ; Maxillary Nerve ; Nerve Block ; Palate ; Palate, Hard ; Young Adult