Korean J Pain.  2024 Oct;37(4):381-384. 10.3344/kjp.24198.

Ultrasound-guided transoral pterygopalatine fossa block: cadaveric elaboration of a novel technique

• Chang KV
• Lin JA
• Tseng TJ
• Hsu CW
• Liao TR
• Wu WT
• Özçakar L

• KMID: 2559700
• DOI: http://doi.org/10.3344/kjp.24198

Figure

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  Fig. 1 The illustration demonstrates the use of a bent needle to perform an ultrasound-guided transoral pterygopalatine fossa block (left subgraph: lateral view; right subgraph; frontal intra-oral view). Colored rectangles indicate the transducer position for Fig. 2 and 4.

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  Fig. 2 With the transducer placed horizontally and caudal to the zygomatic process, the needle appears as a dot (black arrowhead) within the lateral pterygoid muscle (LPM). The transducer position corresponds to the blue rectangle to Fig. 1. MAX: maxilla, LPP: lateral pterygoid plate, MAS: masseter muscle, TEM: temporalis muscle.

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  Fig. 3 The cadaveric horizontal cross-section resembles the scanning plane when the transducer is placed horizontally and caudal to the zygomatic process. Star represents the out-of-plane view of a needle. Images adapted from cadaveric images obtained via the Visible Human Project® of the National Library of Medicine. Excerpts from these images, featured in the VH Dissector, are used with permission from Touch of Life Technologies Inc. TEM: temporalis muscle, LPP: lateral pterygoid plate, LPM: lateral pterygoid muscle.

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  Fig. 4 When the transducer is rotated to the coronal plane, the entire needle trajectory (black arrowheads) can be visualized near the sphenoid bone (SPE) within the lateral pterygoid muscle (LPM). The transducer position corresponds to the red rectangle to Fig. 1. TEM: temporalis muscle.

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  Fig. 5 The cadaveric coronal cross-section resembles the scanning plane when the transducer is placed perpendicular to the zygomatic process. Arrow represents the in-plane view of a needle. Images adapted from cadaveric images obtained via the Visible Human Project® of the National Library of Medicine. Excerpts from these images, featured in the VH Dissector, are used with permission from Touch of Life Technologies Inc. TEM: temporalis muscle, LPM: lateral pterygoid muscle, SPE: sphenoid bone.

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  Fig. 6 In the cadaveric model, the zygomatic process was removed. The methylene blue dye (black arrowheads) is seen to stain the pterygopalatine fossa. SPE: sphenoid bone, MAX: maxilla.

Reference

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