J Dent Anesth Pain Med.  2016 Dec;16(4):245-252. 10.17245/jdapm.2016.16.4.245.

Regional anesthesia for maxillofacial surgery in developing countries

• Kim SM
• Seo MH
• Myoung H
• Lee JH

• KMID: 2366152
• DOI: http://doi.org/10.17245/jdapm.2016.16.4.245

Abstract

Regional anesthesia in the maxillofacial region is safer and more efficient than general anesthesia when its indications are carefully considered. In addition, the majority of medical institutions in developing countries are not well equipped for proper anesthesia and elective surgery. In this review, we describe regional anesthesia and cutaneous nerve divisions in the maxillofacial region. In addition, we summarize detailed regional anesthetic techniques adapted for representative cleft lip cases in developing countries.

Keyword

Cheiloplasty; Developing countries; Maxillofacial surgery; Regional anesthesia

MeSH Terms

Anesthesia
Anesthesia, Conduction*
Anesthesia, General
Cleft Lip
Developing Countries*
Surgery, Oral*

Figure

• 

  Fig. 1 Cutaneous nerve distribution of the maxillofacial region emphasizing trigeminal nerve divisions.

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  Fig. 2 Representative clinical cases for repair or excision operation under regional anesthesia. Facial trauma (A), unknown hard mass near the tempora region (B), fast growing soft mass on the meatus of the ear (C), and a deep biting wound on the lower lip (D).

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  Fig. 3 Representative cases of cleft lip repair in adult patients under regional anesthesia. Cleft microlip (A), unilateral incomplete cleft lip with nostril distortion (B), unilateral incomplete cleft lip only (C), and unilateral complete cleft lip with nasal deviation (D).

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  Fig. 4 Frontal view of the cutaneous nerve distribution on the skin surface (right) and on the skeletal level (left) focusing on the infraorbital nerve.

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  Fig. 5 Clinical appearance of a cheiloplasty performed with only regional anesthesia immediately after surgery (A) and after six months (B).

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