Clinical Experiences and Studies in The Pain Clinic of Kyorin University Hospital : Facial Nerve Block by Infra Meatal Approach

Abstract

From August 1, 1973 until July 30, 1975, the total number of out patients in our clinic was 405. Most of them had so called neuralgia, including cancer pain, facial palsy, and hemi-facial spasm. Facial nerve block by mastoid process approach has been applied for treatment of hemifacial spasm, but this technique is yet difficult one among the various regional nerve blocks and of time consuming procedure. In 21 crania, anatomical features in relation to mastoid process, external meatus and stylomastoid foramen were examined and to alleviate the difficulty of facial nerve block by mastoid process approach, an acupuncture needle or 25-gauge needle (2cm.) is inserted in the anterior edge of the basis of mastoid process, under the infra meatal crest and advanced along tympanomastoid fisture until the needle hit the nerve trunk. In this paper the detail of the new route and technique for facial nerve block was described in its easiness and safety based on the anatomical features. The facial nerve block by infra meatal approach appears to be less painfull for patients.