ArticleJournal of anesthesia2026
Simulation of suprazygomatic and infrazygomatic approaches for maxillary nerve block in children.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Pediatric Maxillary Strut Anatomy: A CT-Based Analysis of Morphometry, Shape, and Pneumatization.Journal of clinical medicine · 2026Article
- Computed Tomography Angiographic Morphometry of the Maxillary Artery in Relation to Mandibular Landmarks.Diagnostics (Basel, Switzerland) · 2026Article
- The Role of Virtual and Augmented Reality in Transsphenoidal Surgical Approaches to the Sellar and Parasellar Area-A Systematic Review.Journal of clinical medicine · 2026Review
- Needle Trajectory Influences Foraminal Contrast Distribution and Pain Reduction Following Paramedian Cervical Interlaminar Epidural Steroid Injection: A Retrospective Study.Medicina (Kaunas, Lithuania) · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
purposeTo compare the feasibility and risk of arterial injury associated with suprazygomatic and infrazygomatic maxillary nerve block approaches in children using 3D virtual reality.
methodsSuprazygomatic, anterior and posterior infrazygomatic approaches were simulated bilaterally using computed-tomography angiography datasets of 89 children (0-18 years). Feasibility and vascular safety were assessed by positioning trajectories from the simulated needle end-point to the skin in respect to bones and maxillary artery, respectively. Solid angles and skin entry areas were quantified, correlated with age, and complemented by quadrant analysis of maxillary artery.
resultsThe suprazygomatic approach was feasible in all 178 attempts and safe in 99.4%. It had the smallest skin entry area with a median of 1.48 [0.98-2.20] cm
conclusionThe suprazygomatic approach showed the most favorable feasibility and vascular safety profile, supporting its preferential use for maxillary nerve block in children. In infrazygomatic approaches, the maxillary artery frequently lay along potential needle trajectories and may represent a safety concern. For anterior infrazygomatic approach, the safest placement was just anterior to mandibular coronoid process, and for posterior just below zygomatic arch.
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