Abstract:
BACKGROUND:Posttraumatic midface pain secondary to injury of the anterior superior alveolar nerve (ASAN) is characterized as pain localized to the central and lateral incisors, canines, and maxilla. This nerve is susceptible to injury and subsequent formation of neuromas after midface trauma. Surgical intervention requires an accurate and precise understanding of the course of the ASAN. METHODS:Dissections of 12 human cadaver heads were conducted to identify the course of the ASAN through the canalis sinuosus (CS). Fifty 1-mm slice face computed tomographic scans were evaluated to document the dimensions and course of the CS. RESULTS:The ASAN branched laterally from the infraorbital nerve before reaching the infraorbital rim in all cadavers. The bifurcation occurred 18 mm posterior to the infraorbital rim (range, 10-30 mm). At a point 25 mm inferior to the infraorbital rim, the ASAN is found 3.4 mm lateral to the piriform aperture (range, 3-4 mm). Radiographic analysis demonstrated a 12.9-mm horizontal length of the CS across the anterior maxilla (SD, 2.2 mm), a distance of 4.8 mm between the piriform aperture and the CS (SD, 1.2 mm), and 11.7 mm vertical length of the CS along the piriform aperture (SD, 3.0 mm). CONCLUSIONS:The ASAN maintains consistent coordinates at specific points along its course through the midface. An improved understanding of the course of the ASAN will guide future diagnosis of injury to this nerve and surgical intervention for patients with posttraumatic midface pain secondary to ASAN injury.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Olenczak JB,Hui-Chou HG,Aguila DJ 3rd,Shaeffer CA,Dellon AL,Manson PNdoi
10.1097/SAP.0000000000000335subject
Has Abstractpub_date
2015-11-01 00:00:00pages
543-7issue
5eissn
0148-7043issn
1536-3708journal_volume
75pub_type
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199208000-00014
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journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
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