Clarius Classroom

Ultrasound-Guided injection of the Mental Nerve

Dr. David Rosenblum

Dr. Rosenblum performs an ultrasound-guided Platelet-Rich Plasma (PRP) injection on a patient experiencing post-dental neuropathy in the mental nerve distribution. Utilizing color and power Doppler modes to safely identify the mental foramen and surrounding vessels, he delivers an out-of-plane injection to the inferior alveolar branch to alleviate the patient’s burning and numbing pain.

Specialties: MSK, Pain Management
Applications: Chin / Jaw, L15

So this is a patient who underwent a dental procedure, and she left with a burning and numbing type of pain in the mental nerve distribution of her face. I coordinated care with her dentist, and we both agreed that we should try an injection. After understanding lidocaine versus lidocaine, steroid or platelet rich plasma.
The patient opted for platelet rich plasma, and we're going to target the inferior alveolar branch of the mental nerve.
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So I'm going to scan for the foramen.
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Color mode.
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Power mode.
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Okay. We can see the blood vessel next to the nerve.
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Does it feel like I'm over that where the pain generates from.
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Okay, I see the nerve at the frame and right here, dead center.
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And I'm going to inject out of plane a little pinch.
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Okay. There.
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You're right. Okay.
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There we go.
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You're right. Did that radiate where your pain was?
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Okay. It's an out of pain injection. So you won't see the needle,
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but you see the tissue distortions from the local anesthetic going in. There's a nerve in the framing right there.
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Okay.
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All right. Hope you feel better. How are you doing?

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