Anatomic study of the infraorbital foramen for radiofrequency neurotomy of the infraorbital nerve.

Abstract:

OBJECTIVE:To examine the anatomy of the infraorbital canal and foramen and the angles at which a radiofrequency probe must be directed to enter the infraorbital foramen and canal, as a guide to performing radiofrequency ablation of the infraorbital nerve in patients with relative or absolute contraindications to lesions of the trigeminal ganglion or posterior root. METHODS:Eleven cadaveric skulls were studied. The infraorbital nerve, after passing through the infraorbital foramen, enters the infraorbital canal and groove in the floor of the orbit before reaching the foramen rotundum. Small probes were placed through the foramen into the infraorbital canal, and pictures were taken in the anteroposterior and sagittal planes. The pictures were analyzed using the ImageTool program (University of Texas Health Science Center, San Antonio, TX) to calculate the anteroposterior and sagittal angles of the probe. The distances of the foramen from the midline, lateral edge of the anterior nasal aperture, and inferior orbital rim were examined. RESULTS:A probe introduced through the cheek from below and medial to the foramen and directed upward and laterally at an angle of approximately 22 degrees in the coronal plane and 120 degrees in the sagittal plane toward a point approximately 26 mm from the midline and 8 mm below the inferior orbital rim will penetrate the infraorbital foramen for placement of the probe's tip in the infraorbital canal. CONCLUSION:The coordinates for placement of the radiofrequency probe through the infraorbital foramen and into the infraorbital canal are reviewed, along with a discussion of pitfalls in radiofrequency ablation of the nerve.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Rahman M,Richter EO,Osawa S,Rhoton AL Jr

doi

10.1227/01.NEU.0000336327.10368.79

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

423-7; discussion 427-8

issue

5 Suppl 2

eissn

0148-396X

issn

1524-4040

pii

00006123-200905001-00023

journal_volume

64

pub_type

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