Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center...Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.展开更多
<strong>Objective:</strong> The aim of this study was to observe and investigate the location of mental foramen, providing scientific and reasonable anatomic basic for clinical mental nerve block. <stro...<strong>Objective:</strong> The aim of this study was to observe and investigate the location of mental foramen, providing scientific and reasonable anatomic basic for clinical mental nerve block. <strong>Methods:</strong> The shape, orientations, relationship with teeth and number of accessory mental foramina in 50 (100 side) adult mental foramina were observed. The long and short diameters of the mental foramen and the distance between the mental foramen and the peripheral anatomical markers were measured by a vernier caliper, and statistical analysis of the data was performed to obtain the final results. <strong>Results:</strong> The probability of mental foramen being elliptical in shape accounted for 27%, circular for 73%;10% of the mental foramen openings are outward and 90% are outward and upward;The mental foramina were located under the first premolars in 20%, under the second premolars in 75%, and 5% situated in the bottom of the first molars. The incidence of accessory mental foramina was 1%;the long diameter of the mental foramen was (2.42 ± 0.71) mm, and the short diameter of the mental foramen was (2.15 ± 0.14) mm;the vertical distance from the mental foramen center to the alveolar crest and the lower margin of the mandible were (14.09 ± 3.23) mm and (14.56 ± 1.74) mm;the distance between the midpoints of the vertical line to the center of the mental foramen was (1.26 ± 0.97) mm;the horizontal distance from the center of the mental foramen to the anterior median line was (23.57 ± 1.82) mm. <strong>Conclusion:</strong> The point of mental nerve block was selected below and behind the second premolars, above the midline of the mandible. The distance from the anterior median line was 2.5 cm, and the mental foramen was explored forward and downward after the insertion.展开更多
文摘Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.
文摘<strong>Objective:</strong> The aim of this study was to observe and investigate the location of mental foramen, providing scientific and reasonable anatomic basic for clinical mental nerve block. <strong>Methods:</strong> The shape, orientations, relationship with teeth and number of accessory mental foramina in 50 (100 side) adult mental foramina were observed. The long and short diameters of the mental foramen and the distance between the mental foramen and the peripheral anatomical markers were measured by a vernier caliper, and statistical analysis of the data was performed to obtain the final results. <strong>Results:</strong> The probability of mental foramen being elliptical in shape accounted for 27%, circular for 73%;10% of the mental foramen openings are outward and 90% are outward and upward;The mental foramina were located under the first premolars in 20%, under the second premolars in 75%, and 5% situated in the bottom of the first molars. The incidence of accessory mental foramina was 1%;the long diameter of the mental foramen was (2.42 ± 0.71) mm, and the short diameter of the mental foramen was (2.15 ± 0.14) mm;the vertical distance from the mental foramen center to the alveolar crest and the lower margin of the mandible were (14.09 ± 3.23) mm and (14.56 ± 1.74) mm;the distance between the midpoints of the vertical line to the center of the mental foramen was (1.26 ± 0.97) mm;the horizontal distance from the center of the mental foramen to the anterior median line was (23.57 ± 1.82) mm. <strong>Conclusion:</strong> The point of mental nerve block was selected below and behind the second premolars, above the midline of the mandible. The distance from the anterior median line was 2.5 cm, and the mental foramen was explored forward and downward after the insertion.
