Vertiginous syndrome associated with incorrect anesthesia technique to block the maxillary nerve via the greater palatine canal: Case report and anatomic correlation with cadaveric parts

Reinaldo Soto; Felipe Cáceres; Jorge Lankin

doi:10.4067/S0717-95022014000300007

Vertiginous syndrome associated with incorrect anesthesia technique to block the maxillary nerve via the greater palatine canal: Case report and anatomic correlation with cadaveric parts

Título traducido de la contribución: Síndrome Vertiginoso Asociado a Técnica Anestésica Incorrecta para Bloquear el Nervio Maxilar vía Canal Palatino Mayor:: Reporte de caso y correlación anatómica en piezas cadavéricas

Reinaldo Soto^*, Felipe Cáceres, Jorge Lankin

^*Autor correspondiente de este trabajo

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

Resumen

La técnica anestésica vía canal palatino mayor tiene como objetivo abordar al nervio maxilar en la fosa pterigopalatina, anestesiando un gran territorio, incluyendo la pulpa y periodonto de la hemiarcada correspondiente. Después de haber aplicado esta técnica en una paciente y no obteniendo el resultado esperado, esta comenzó a experimentar vértigo, náuseas, sensación de líquido en el oído y vómitos. Fue evaluada en el servicio de urgencias del Hospital Parroquial de San Bernardo y en una Clínica Privada, sin lograr un diagnóstico preciso y realizando solo un tratamiento sintomático. Al día siguiente fue dada de alta con baja sintomatología, la cual desapareció totalmente durante el día. Se propone la hipótesis de una difusión del anestésico hacia el oído medio e interno mediante el tubo auditivo. Esto explicaría por un lado la sintomatología vestibular y por otro la ausencia de anestesia en los dientes y territorios esperados. Además se realizó una correlación anatómica en cadáveres, utilizando 8 hemicabezas conservadas y siguiendo el posible trayecto de la aguja desde la mucosa palatina hasta el orificio faríngeo de la tuba auditiva. Se concluyó que el síndrome vertiginoso experimentado por la paciente se pudo deber a una técnica fallida al nervio maxilar vía canal palatino mayor con ingreso de la aguja al tubo auditivo, difundiendo el anestésico hacia el oído medio.

Título traducido de la contribución	Síndrome Vertiginoso Asociado a Técnica Anestésica Incorrecta para Bloquear el Nervio Maxilar vía Canal Palatino Mayor:: Reporte de caso y correlación anatómica en piezas cadavéricas
Idioma original	Inglés
Páginas (desde-hasta)	786-788
Número de páginas	3
Publicación	International Journal of Morphology
Volumen	32
N.º	3
DOI	https://doi.org/10.4067/S0717-95022014000300007
Estado	Publicada - sep. 2014

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© 2014 Universidad de la Frontera. All rights reserved.

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title = "Vertiginous syndrome associated with incorrect anesthesia technique to block the maxillary nerve via the greater palatine canal: Case report and anatomic correlation with cadaveric parts",

abstract = "The anesthetic technique through the greater palatine canal seeks to block the maxillary nerve in the pterygopalatine fossa and anesthetize al large area, including the pulp and periodontium of the arch in question. After applying this technique in a patient, it failed to obtain the expected result. The patient began to experience dizziness, nausea, vomiting and the sensation of fluid in the ear. She was evaluated in both the emergency room of the Hospital Parroquial de San Bernardo and at a private clinic without accurate diagnosis. Only symptomatic treatment was provided. The next day she was discharged with reduced symptoms, which disappeared completely during the day. We propose the hypothesis of a diffusion of the anesthetic solution into the middle and inner ear through the auditory tube. This diffusion would explain the vestibular symptoms and the absence of anesthesia in the expected areas. We carried out an anatomic correlation in cadavers, following the path of a needle from the palatal mucosa to the pharyngeal opening of auditory tube. We conclude that the vertiginous syndrome could be due to an incorrect application of the technique, with the needle entering the auditory tube and spreading the anesthetic solution into the middle ear.",

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doi = "10.4067/S0717-95022014000300007",

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Vertiginous syndrome associated with incorrect anesthesia technique to block the maxillary nerve via the greater palatine canal: Case report and anatomic correlation with cadaveric parts. / Soto, Reinaldo ; Cáceres, Felipe; Lankin, Jorge.
En: International Journal of Morphology, Vol. 32, N.º 3, 09.2014, p. 786-788.

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

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AB - The anesthetic technique through the greater palatine canal seeks to block the maxillary nerve in the pterygopalatine fossa and anesthetize al large area, including the pulp and periodontium of the arch in question. After applying this technique in a patient, it failed to obtain the expected result. The patient began to experience dizziness, nausea, vomiting and the sensation of fluid in the ear. She was evaluated in both the emergency room of the Hospital Parroquial de San Bernardo and at a private clinic without accurate diagnosis. Only symptomatic treatment was provided. The next day she was discharged with reduced symptoms, which disappeared completely during the day. We propose the hypothesis of a diffusion of the anesthetic solution into the middle and inner ear through the auditory tube. This diffusion would explain the vestibular symptoms and the absence of anesthesia in the expected areas. We carried out an anatomic correlation in cadavers, following the path of a needle from the palatal mucosa to the pharyngeal opening of auditory tube. We conclude that the vertiginous syndrome could be due to an incorrect application of the technique, with the needle entering the auditory tube and spreading the anesthetic solution into the middle ear.

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Vertiginous syndrome associated with incorrect anesthesia technique to block the maxillary nerve via the greater palatine canal: Case report and anatomic correlation with cadaveric parts

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