The Infraorbital Foramen Location in the Perinatal Maxilla: Implications for Infraorbital Nerve Block

Abstract

Bilateral infraorbital nerve block is performed in infants for the management of pain after cleft‐lip repair. The procedure involves the injection of anesthetic near the emergence of the infraorbital nerves in the face at the infraorbital foramen. In adults, infraorbital foramen location is oftentimes estimated via measurements from the lateral nasal aperture and the infraorbital margin; however, these measurements have not been described in the perinatal population. Therefore, this study assesses the distances from the lateral nasal aperture and the infraorbital margin to the infraorbital foramen in 66 fetal and infantile maxillae ranging from 5 months intrauterine development to 15 months postnatal development. The best‐fit linear model for IOF location is with regard to the distance from the lateral nasal aperture to the IOF. The model is given by the formula Distance = 0.1747 × Age (in developmental months) + 4.4433 and has an r2 value of 0.6145. Linear modeling with respect to the distance from the infraorbital margin to the IOF however was poor with regard to goodness‐of‐fit (r2 = 0.1636). The distance from the infraorbital foramen at 5 months intrauterine age was 2.9mm while, at one year post‐natal was 3.4mm (difference = 0.5mm) and therefore represents little change in maxillary growth in that dimension. On the other hand distance from the lateral aperture at 5 months development was 5.3 mm and at one year was 7.6mm (difference = 2.3mm). The results of this study suggest that the IOF location can be approximated, particularly with regard to the distance from the lateral aperture as a function of age. The results of the study will help to optimize infraorbital nerve block in young patients recovering from cleft‐lip surgery.Support or Funding InformationWV Research Challenge Fund [HEPC.dsr.17.06]This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.