Development of the method of conducting anesthesia of zygomaticofacial nerve in people with different face shape and its clinical evaluation

Introduction
The branching of the trigeminal nerve on the face has an individual anatomical variability. The individual variability of innervation of the maxillofacial area should be taken into account during local anesthesia.

Objectives
The purpose of the study was to develop a method of conducting anesthesia of the zygomaticofacial nerve.

Material and methods
Craniometric examinations were performed on 32 natural skulls of corpses of various ages, and 60 images of patients’ head section were completed in a 3D reconstruction by multi-detector row spiral computed tomography. The cranial index was determined by counting the number of zygomaticofacial foramina on each skull, taking into account the peculiarities of their location. Sixty-one surgical dental patients with planned surgical interventions on the lateral facial area beforehand participated in this clinical observation. A developed technique of conductive anesthesia of the zygomaticofacial nerve was applied in thirty patients, and its effectiveness was compared with a known method.

Results
A certain feature in the localization of zygomaticofacial foramina on the lateral (facial) surface of zygomatic bone, depending on the type of structure of the skull was discovered.

Conclusions
Taking into account the results of craniometric studies as well as the individual topographic and anatomical features of zygomaticofacial nerve branching in people with different types of skull structure, the technique of performing anesthesia of the branches of zygomaticofacial nerve was developed. In order to anesthetize this nerve in people with broad and oblong face shape, anatomical variability of its branching should be considered.