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

The anesthetic technique through the greater palatine canal seeks to block the maxillary nerve in the pterygopalatine fossa and anesthetize a 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....

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Autores principales: Soto,Reinaldo, Cáceres,Felipe, Lankin,Jorge
Lenguaje:English
Publicado: Sociedad Chilena de Anatomía 2014
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022014000300007
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Sumario:The anesthetic technique through the greater palatine canal seeks to block the maxillary nerve in the pterygopalatine fossa and anesthetize a 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.