SURFACE analgesia is almost universally employed in antral puncture in adults. The efficiency of this method in ensuring a painless puncture is far from constant as many patients would readily testify. Inadequate analgesia may in some cases result from poor technique or lack of care on the part of the rhinologist. In other instances failure may be due to problems specifically related to surface application of drugs.
Problems of Access.—Antral puncture is carried out through the lateral wall of the inferior meatus of the nose. The nerve supply of this area is derived from the greater palatine and anterior superior dental nerves. The latter innervation is important as the nerve enters the meatus through its lateral wall and thus to ensure complete analgesia, any surface agent must be applied directly to this area. This is a relatively inaccessible region, ease of access depending on the position and size
Gibb AG. Infiltration Analgesia in Antral Puncture. Arch Otolaryngol. 1968;88(2):205–206. doi:10.1001/archotol.1968.00770010207021
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