Ultrasound-Guided Intervention for Treatment of Trigeminal Neuralgia: An Updated Review of Anatomy and Techniques

Table 1

Summary of the anatomy and guided injection techniques of the trigeminal nerve and its branches.

Nerve	Bony landmark	Sensory innervation of the nerve	Accompanying vessel	Adjacent muscle	Transducer selection	Transducer placement	Needle trajectory	Ultrasound-guided technique
Supraorbital nerve	Supraorbital notch at the medial one-third of the supraorbital margin about 2 to 3 cm lateral to the midline	Upper eyelid, forehead, and the anterior half of the scalp	Supraorbital artery and vein	Corrugator supercilii muscle	Linear transducer	Medial one-third of the supraorbital margin	From lateral to medial	In-plane
Infraorbital nerve	Infraorbital foramen 1 cm below the midpoint of the infraorbital margin	Lower eyelid, half side of the nose, and the upper lip	Infraorbital artery and vein	Levator labii superioris muscle	Linear transducer	Body of the maxilla parallel to and 1 cm below the infraorbital margin	From lateral to medial	In-plane
Mental nerve	Mental foramen 3 cm lateral to the midline and 1 cm above the lower border of the mandible	Skin of the chin and lower lip and mucosa of the lower lip	Mental artery and vein	Depressor labii inferioris muscle	Linear transducer	3 cm lateral to the midline and 1 cm above and parallel to the lower border of the mandible	From lateral to medial	In-plane
Auriculotemporal nerve	Posterior zygomatic arch in front of the tragus	Anterior ear and the posterior part of the skin over the temporalis muscle	Superficial temporal artery	Temporalis muscle	Linear transducer	Parallel to the posterior part of the zygomatic arch just above the level of the tragus	From posterior to anterior	In-plane
Maxillary nerve	Pterygopalatine fossa anterior and medial to the lateral pterygoid plate	Lower eyelid, cheek, nose, upper lip, upper teeth and gums, roof of the pharynx, the sphenoid and ethmoid sinuses and meninges	Sphenopalatine artery	Lateral pterygoid muscle	Curvilinear transducer	Distal and parallel to the zygomatic arch to bridge the coronoid and the condylar processes	From posterior to anterior	Out-of-plane
Mandibular nerve	Posterior to the lateral pterygoid plate	Anterior two-thirds of the tongue, teeth, and mucosa and periosteum of the mandible, skin of the chin and the lower lip, and the skin over the mandible	Middle meningeal artery	Lateral and medial pterygoid muscles	Curvilinear transducer	Distal and parallel to the zygomatic arch to bridge the coronoid and the condylar processes	From anterior to posterior	Out-of-plane