PMC3546218_01
A photograph of the radiofrequency needle placement 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. (C) Lateral view in a human skull model, which is empirically depicted. The ultrasound transducer was initially applied longitudinally at the lateral side of the nose and rotated slightly clockwise. Then, the transducer was moved laterally until the left infraorbital foramen was identified.
kjpain-26-84-g001.jpg
PMC3546218_01_kjpain-26-84-g001.jpg
F1
We scanned his face from medial to lateral in the sagittal plane along the left lower orbital margin (Fig. 1).
An ultrasound image of the radiofrequency needle in the infraorbital foramen (10-12 MHz linear transducer, long-axis in-plane technique). The protuberance within the hyperechoic line indicates the infraorbital foramen. The radiofrequency needle through the infraorbital foramen is indicated with arrow heads.
kjpain-26-84-g002.jpg
PMC3546218_01_kjpain-26-84-g002.jpg
F2
We easily identified the infraorbital foramen with a hyperechoic protuberance (Fig. 2). 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 infraorbital foramen under USG (Fig. 2).
Fluoroscope images during pulsed radiofrequency treatment of the left infraorbital nerve. (A) Anteroposterior view. (B) Lateral view. Fluoroscopic images show that the needle was in the infraorbital foramen and not in the orbital cavity. No vascular uptake of radio-contrast agent was observed.
kjpain-26-84-g003.jpg
PMC3546218_01_kjpain-26-84-g003.jpg
F3
Following negative aspiration, 0.5 ml of radio-contrast agent was injected to confirm no vascular uptake through the infraorbital artery (Fig. 3).