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Local anaesthetic techniques in endoscopic sinonasal surgery: a contemporaneous review

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  24 November 2021

E Watts ,
A Thompson ,
M Pankhania ,
O Okonkwo  and
S Ahmed
E Watts
Affiliation:
Department of ENT Surgery, Queen Elizabeth Hospital, Birmingham, UK
A Thompson
Affiliation:
Department of Oral and Maxillofacial Surgery, Royal Hallamshire Hospital, Sheffield, UK
M Pankhania
Affiliation:
Department of ENT Surgery, Queen Elizabeth Hospital, Birmingham, UK
O Okonkwo
Affiliation:
Department of ENT Surgery, Queen Elizabeth Hospital, Birmingham, UK
S Ahmed*
Affiliation:
Department of ENT Surgery, Queen Elizabeth Hospital, Birmingham, UK
*
Author for correspondence: Mr S Ahmed, Department of ENT Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2GW, UK E-mail: shahz.ahmed@nhs.net
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Abstract

Objective

Endoscopic endonasal surgery is a minimally invasive technique that has revolutionised the management of complex neurosurgical, otolaryngological, skull-base and craniofacial lesions. Traditionally performed under general anaesthetic, this study explores the growing role of local anaesthetic techniques.

Method

A contemporaneous review of modified dental techniques and intraoral anatomy provides a supportive guide for performing endoscopic sinus surgery under local anaesthetic.

Results

The practical procedures for four midfacial nerve blocks are described with relevance to endoscopic surgery under local anaesthetic. Anatomy, surgical technique and potential complications are discussed for the incisive foramen block, sphenopalatine ganglion block (via endonasal approach), maxillary nerve block (via the greater palatine foramen and the transoral lateral pterygoid plate approach) and transcutaneous approach to the pterygomaxillary fissure.

Conclusion

Ultimately, such techniques may extend the safety and efficacy of endoscopic sinus surgery, limit surgical risk and increase satisfaction for patients, surgeons and healthcare managers alike.

Keywords

Local Anesthetic Endoscopic Sinus Surgery

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 8 , August 2022 , pp. 683 - 691
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Mr S Ahmed takes responsibility for the integrity of the content of the paper

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