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Case Reports
. 2017 Sep;10(3):208-211.
doi: 10.1055/s-0036-1592088. Epub 2016 Aug 23.

Injured Anterior Superior Alveolar Nerve Endoscopically Resected within Maxillary Sinus

Amir H Dorafshar  1 , A Lee Dellon  1 , Eric Lee Wan  1 , Sashank Reddy  1 , Victor W Wong  1
Affiliations
Case Reports

Injured Anterior Superior Alveolar Nerve Endoscopically Resected within Maxillary Sinus

Amir H Dorafshar et al. Craniomaxillofac Trauma Reconstr. 2017 Sep.

Abstract

Posttraumatic facial pain is due to an injured nerve, most often a branch of the trigeminal nerve. While surgical approaches to injuries of the supraorbital, supratrochlear, infraorbital, and inferior alveolar nerves have been reported, an injury to the anterior superior alveolar nerve (ASAN) has not been reported. An algorithm is proposed for the diagnosis of injury to the ASAN versus the infraorbital nerve itself. A case is reported in which pain relief was achieved by dividing the ASAN within the maxillary sinus, leaving the proximal end exposed within the sinus at the level of the orbital floor.

Keywords: anterior superior alveolar nerve; infraorbital nerve; neuroma.

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Figures

Fig. 1
Fig. 1
Site of pain, in the gingiva of the left central and lateral incisor.
Fig. 2
Fig. 2
CT coronal image demonstrating normal canalis sinuosis (yellow arrow) on the right with damaged canalis sinuosis on the left.
Fig. 3
Fig. 3
Intraoperative views: ( a ) incision in the left upper lip sulcus, with first view of the anterior superior alveolar nerve (ASAN) exiting inferior to the infraorbital nerve following maxillary antrotomy. ( b ) Antrotomy view of the ASAN in its horizontal course, being held by a nerve hook. ( c ) Brilliant green dye marking the anatomic pathway of the ASAN from the antrum to the tooth origins.
Fig. 4
Fig. 4
Schematic showing the surgical plan and anatomic course of anterior superior alveolar nerve in yellow.
See this image and copyright information in PMC

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