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Periorbital Region and Tear Trough
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Colin M. Morrison, Ruth Tevlin, Steven Liew, Vitaly Zholtikov, Haideh Hirmand, Steven Fagien
The lower eyelid: Sensory innervation is from the inferior palpebral branch of the infraorbital nerve (Figure 3.15). The inferior palpebral branch is often bifurcated, with one branch traveling laterally and the other medially, and sometimes the branch only innervates the medial or lateral part of the lower lid. If the lateral branch is absent, the zygomaticofacial branch of the zygomatic nerve may compensate; if the medial branch is missing, the external nasal branch may innervate the area. A palpebral branch of the infratrochlear nerve may also reach the medial aspect of the lower lid [35].
Local Infiltration Anesthesia
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
Christie T. Ammirati, George J. Hruza
The innervation to the nose is similar to the ear in that circumferential infiltration of anesthesia blocks sensory input to all but its central portion. Branches of the infraorbital nerve supply the lateral nose and inferior nasal ala, and the infratrochlear nerve innervates the superior portion. The nasal tip and columella receive input from the external nasal branches of the anterior ethmoidal nerve, which exit at the junction of the nasal bone and lateral cartilages. The first step in this block is to infiltrate within the alar sulcus extending superiorly along the nasofacial crease (Fig. 6). The needle is then redirected inferomedially, and anesthesia is infiltrated along the nostril sill to the columella, extending over the anterior nasal spine. This procedure is subsequently repeated on the opposite side. Next, the needle is placed midline at the junction of the dorsum and root of the nose. Anesthetic is infiltrated laterally toward the medial canthus and then inferiorly within the nasofacial crease on both sides. This ring of anesthesia encircles the nose and anesthetizes the entire cutaneous surface except for the tip, which is supplied by the anterior ethmoidal nerve. This nerve emerges at the distal edge of the nasal bone where it joins the upper lateral cartilages. Once this junction has been palpated, the needle is inserted in the midline and anesthesia is infiltrated bilaterally in inferolateral directions toward both sides of the nose to complete the block.
Local Anesthetics
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Alexander C. Allori, Dunya M. Atisha, Jeffrey R. Marcus
The upper eyelid is innervated medially by the infratrochlear nerve and laterally by the lacrimal nerve. The infratrochlear nerve is also anesthetized during the supratrochlear–supraorbital nerve blockade just described. Alternatively, it can be targeted directly by a 2 or 3 ml infiltration 1 cm medial to the supraorbital notch. The lacrimal nerve may be anesthetized by infiltrating 1 ml of local anesthetic superior to the lateral canthus tendon.6
Biopsy of recurrent nasolacrimal duct obstruction using sheath-guided dacryoendoscopy
Published in Orbit, 2019
Kosuke Ueda, Akihide Watanabe, Norihiko Yokoi, Manabu Sugimoto, Hideki Fukuoka, Katsuhiko Shinomiya, Shigeru Kinoshita, Saul Rajak, Dinesh Selva
All procedures were performed under local anaesthesia, which was administered by nasolacrimal syringing with 4% lidocaine (4%) and infratrochlear nerve block with 2% lidocaine. Dacryoendoscopic-guided biopsy collection involved (1) direct visualisation of the lesion with the dacryoendoscope (Fiber Tech Co., Ltd., Tokyo, Japan), (2) placement of a lacrimal sheath (Argo Cure System Corporation, Toyota, Japan) over the dacryoendoscope with the tip protruding 1–2 mm over the tip of the scope, (3) probing through the obstruction with direct visualisation of the patent distal duct and nasal cavity (Figure 1), (4) scraping of a biopsy specimen from the wall of the NLD in the region of the recurrent obstruction with the sheath-covered dacryoendoscope, (5) aspiration of the biopsy into a 1–2 mm area of the protruding sheath lumen (Figure 2), (6) removal of the endoscope with aspiration maintained, and (7) removal of the specimen by expelling it from the irrigation channel. All patients subsequently underwent SGI.