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The use of local anesthesia in blocking a branch of the trigeminus nerve is frequent in office work, more so perhaps since the introduction of the electrosurgical unit. In induction of infraorbital nerve block I found myself dissatisfied with the usual method of introducing the needle through the cheek 1 cm. below the midpoint of the lower margin of the orbit: The foramen often had to be "fished for," and hematoma was liable to form. The oral approach is not desirable from the standpoint of surgical asepsis. One day I went lower—through the nasolabial sulcus—and found that the needle slipped into the foramen with the greatest of ease, without formation of hematoma.
The landmarks (figure, A) to be observed in this approach are the anterior nasal spine (or the midline junction of the columella of nose and the philtrum of lip), the nasolabial furrow, the fold produced by the
Skillern P. A NEW APPROACH IN INDUCTION OF INFRAORBITAL NERVE BLOCK. Arch NeurPsych. 1941;46(6):1076-1077. doi:10.1001/archneurpsyc.1941.02280240131009