PMC3903807_01
PMC3903807_02
PMC3903807_03
A photograph of the needle placement in the mental foramen under ultrasound guidance (10-12 MHz linear transducer). (A) In the actual patient. (B) Anterior view in a human skull model, which is empirically depicted. The transducer (white box) was moved like (1) for identifying the mental foramen and mental foramen was positioned at the end of transducer (2). (C) An ultrasound image of the radiofrequency needle in the mental foramen (10-12 MHz linear transducer, long-axis in-plane technique). The cleft within the hyperechoic line indicates the mental foramen. The radiofrequency needle has passed through the mental foramen and is indicated with arrow heads.
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PMC3903807_03_kjpain-27-81-g001.jpg
F1
We scanned her mandible in the cephalad direction from the inferior border of the mandible and easily identified the mental foramen with a hypoechoic cleft (Fig. 1).
Fluoroscopic images during pulsed radiofrequency treatment of the left mental nerve of the mandibular branch. (A) Anteroposterior view. (B) Lateral view. Fluoroscopic images show that the needle was in the mental foramen. No vascular uptake of radio-contrast agent was observed.
kjpain-27-81-g002.jpg
PMC3903807_03_kjpain-27-81-g002.jpg
F2
A radiofrequency needle (10 cm) insulated with a 5-mm active tip (22 G, SMK-C10; Radionics Inc, Burlington, MA, USA) was advanced slightly via the mental foramen under US assistance (Fig. 2). Following negative aspiration, 0.5 ml of radio-contrast agent (Omnipaque GE Healthcare, Cork, Ireland) was injected to confirm no vascular uptake through the mental branch of the inferior alveolar artery (Fig. 2).