An alternative technique is to identify the supraorbital ridge by palpation. The needle is then inserted lateral to the ridge and is advanced medially selleck chemicals into the subcutaneous tissue. After

negative aspiration, the solution is injected. Pressure should be applied to avoid periorbital hematoma. Drugs to use: lidocaine 1%-2% (10-20 mg/mL) and/or bupivacaine 0.25%-0.5% (2.5-5 mg/mL). If a combination of the 2 drugs is used, the recommended volume ratio (lidocaine/bupivacaine) is 1:1-1:3. We do not recommend the use of corticosteroids in this area, or in other trigeminal territories. Volume of injection: 0.2-1.0 mL per nerve. For patients who require repeated injections, the recommended frequency of treatments is once every 2-4 weeks, depending on the response of the individual patient. The SON is the larger of the 2 terminal branches of the frontal nerve. It courses through the supraorbital

notch or foramen and supplies palpebral filaments to the upper eyelid and conjunctiva. It then ascends on the forehead with the supraorbital artery and divides into medial and lateral branches, which supply the skin of the scalp almost as far back as the lambdoid suture. The medial branch pierces the occipitofrontalis muscle to reach the skin, while the lateral branch penetrates the epicranial aponeurosis over the forehead and scalp. Postganglionic sympathetic HCS assay fibers, which innervate the sweat glands of the supraorbital area, are thought to travel in the SON. The supraorbital notch or foramen lies on the superior aspect of an imaginary line coursing caudally and intersecting the pupil, the infraorbital foramen, and the mental foramen. Location of injection: above the supraorbital Idoxuridine notch. Technique of injection: use a 1 mL syringe with a 30-gauge, 0.5-inch needle. Insert

the needle at the corrugator muscle, at the mid-pupillary line (Fig. 2 —). After negative aspiration, the solution may be injected at a depth of 3-4 mm. An alternative technique is to identify the supraorbital notch by palpation, at the superior margin of the orbit, mid-pupillary line. The needle is then advanced medially and inserted at a slight angle to avoid entering the foramen. The solution then may be injected at a depth of 3-4 mm, after negative aspiration. Pressure should be applied to avoid periorbital hematoma. Alternatively, after blocking the STN, redirect the needle laterally and inject. Drugs used and volume of injections are the same as for the STN block. The ATN surfaces onto the face from behind the temporomandibular joint (TMJ) within the superior surface of the parotid gland. It ascends close to the superficial temporal artery, passes over the posterior portion of the zygoma, and divides into superficial temporal branches. The cutaneous branches of the ATN supply the tragus and part of the adjacent auricle of the ear and the posterior part of the temple. The ATN also provides sensory innervation to the majority of the TMJ.