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J Neurol Surg B Skull Base 2021; 82(S 03): e271-e277
DOI: 10.1055/s-0040-1701530
Original Article

Morphometric and Topographic Features of Stylomastoid Foramen and its Clinical Significance in Facial Nerve Block

Tunç Kutoğlu
1   Department of Anatomy, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey
,
Murat Çetkin
1   Department of Anatomy, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey
,
Ömer Turan
2   Department of Forensic Medicine, İstanbul Medeniyet University, İstanbul, Turkey
,
Selin Bayko
1   Department of Anatomy, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey
,
İlda Sinem Yarkan
1   Department of Anatomy, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey
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Abstract

Objective This study aims to determine the topographic localization of the stylomastoid foramen (SF) and its morphometric relationship with the surrounding bony landmarks.

Design A descriptive anatomical study.

Setting Anatomy Laboratory of the Faculty of Medicine.

Participants Measurements were performed on 53 dry temporal bones.

Main Outcome Measures On the inferior and lateral aspects of photographic images, lines and angles were defined. The most lateral end of the SF (SF1) and the transverse medial–lateral line that passes through the upper end of the anterior border of mastoid process (line 1) were used as reference points for topographic evaluation. The upper end of the anterior border of mastoid process (A) and the tip of mastoid process (B) were considered in defining angles. The dates about SF were evaluated using the ImageJ 1.46r software and digital caliper.

Results SF1 was classified into three different types based on its topographical localization, stated as Type 1, Type 2, and Type 3. In Type 1, SF1 was located anterior to line 1 (54.7%). SF1 was located posterior to line 1 in Type 2 (34.0%). SF1 was located just over line 1 in Type 3 (11.3%). We also detected angular variations between these types in the inferior and lateral aspects.

Conclusion The recommended angles of application are 30 degrees on the horizontal plane and 55 degrees on the sagittal plane for Type 1 when point B is considered. A needle length below 10 mm is more suitable to minimize the potential complications of the nerve block.

Keywords

stylomastoid foramen - Nadbath block - morphometry


Publication History

Received: 15 August 2019

Accepted: 24 December 2019

Article published online:
06 March 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Schimek F, Fahle M. Techniques of facial nerve block. Br J Ophthalmol 1995; 79 (02) 166-173
    CrossrefPubMedGoogle Scholar
  • 2 Takahashi T, Dohi S. Hemifacial spasm: a new technique of facial nerve blockade. Br J Anaesth 1983; 55 (04) 333-337
    CrossrefPubMedGoogle Scholar
  • 3 Garg A. Anesthesia in cataract surgery. In: Agarwal S, Agarwal A, Agarwal A. eds. Phacoemulsification. New Delhi: Taylor & Francis; 2004. -162
    CrossrefGoogle Scholar
  • 4 Nadbath RP. Rehmani. Facial nerve block. Am J Ophthalmol 1963; 55: 143-146
    CrossrefPubMedGoogle Scholar
  • 5 Wong DHW. Regional anaesthesia for intraocular surgery. Can J Anaesth 1993; 40 (07) 635-657
    CrossrefPubMedGoogle Scholar
  • 6 Garg A. Anesthesia in cataract surgery. In: Garg A, Fry LL, Tabin G, Pandey SK, Gutierrez-Carmona FJ. eds. Clinical Practice in Small Incision Cataract Surgery. New Delhi: Taylor & Francis; 2004: 224
    Google Scholar
  • 7 Spaeth GL. Total facial nerve palsy following modified O'Brien facial nerve block. Ophthalmic Surg 1987; 18 (07) 518-519
    PubMedGoogle Scholar
  • 8 Koenig SB, Snyder RW, Kay J. Respiratory distress after a Nadbath block. Ophthalmology 1988; 95 (09) 1285-1287
    CrossrefPubMedGoogle Scholar
  • 9 Cofer HF. Cord paralysis after Nadbath facial nerve block. Arch Ophthalmol 1986; 104 (03) 337
    CrossrefPubMedGoogle Scholar
  • 10 Standring S. Grays's Anatomy: The Anatomical Basis of Clinical Practice. 41th ed. London: Elsevier; 2016: 416
    Google Scholar
  • 11 O'Brien CS. Local anesthesia in ophthalmic surgery. JAMA 1928; 90: 8-13
    CrossrefPubMedGoogle Scholar
  • 12 Van Lint H. Paralysie palpebrale temporaire provoquee dans l'operation de la cataracte. Ann Ocul (Paris) 1914; 151: 420-424
    PubMedGoogle Scholar
  • 13 Atkinson WS. Akinesia of the orbicularis. Am J Ophthalmol 1953; 36 (09) 1255-1258
    CrossrefPubMedGoogle Scholar
  • 14 Khurana AK. Ophthalmology. New Delhi: New Age International Ltd; 2003: 572
    Google Scholar
  • 15 Birt CM, Dixon WS, Dionne CL. Vocal cord paralysis with Nadbath facial block. Can J Ophthalmol 1994; 29 (05) 231-233
    PubMedGoogle Scholar
  • 16 Gray AT, Hynson JM. Pulmonary edema after Nadbath and retrobulbar blocks. Anesth Analg 1994; 78 (06) 1177-1179
    PubMedGoogle Scholar
  • 17 Rabinowitz L, Livingston M, Schneider H, Hall A. Respiratory obstruction following the Nadbath facial nerve block. Arch Ophthalmol 1986; 104 (08) 1115
    CrossrefPubMedGoogle Scholar
  • 18 Shoch D. Complications of the Nadbath facial nerve block. Arch Ophthalmol 1986; 104 (08) 1114-1115
    CrossrefPubMedGoogle Scholar
  • 19 Sharma N, Varshney R. Morphometry of stylomastoid foramen and its clinical application in facial nerve block. Saudi J Anaesth 2015; 9 (01) 60-63
    CrossrefPubMedGoogle Scholar
  • 20 Lindquist TD, Kopietz LA, Spigelman AV, Nichols BD, Lindstrom RL. Complications of Nadbath facial nerve block and a review of the literature. Ophthalmic Surg 1988; 19 (04) 271-273
    PubMedGoogle Scholar
  • 21 Wilson CA, Ruiz RS. Respiratory obstruction following the Nadbath facial nerve block. Arch Ophthalmol 1985; 103 (10) 1454-1456
    CrossrefPubMedGoogle Scholar