Trigeminal (Gasserian) Ganglion, Maxillary Nerve, and Mandibular Nerve Blocks

  • Samer N. NarouzeEmail author


The Gasserian (trigeminal) ganglion lies within Meckel’s cavity in the middle cranial fossa close to the petrous bone. It is surrounded medially by the cavernous sinus, superiorly by the inferior surface of the temporal lobe, and posteriorly by the brain stem. Gasserian ganglion has three divisions with a characteristic somatotopic arrangement, in that the ophthalmic division (V1) is the most craniomedial and the mandibular division (V3) is the most caudolateral. The maxillary branch (V2) lies in between. The ophthalmic nerve exits through the superior orbital fissure, the maxillary nerve through the foramen rotundum, and the mandibular nerve through the foramen ovale.

This chapter will cover the indications and techniques for trigeminal ganglion, maxillary nerve, and mandibular nerve blocks. Other trigeminal terminal branches blocks were discussed in a previous chapter.


Trigeminal Neuralgia Middle Cranial Fossa Mandibular Nerve Pterygopalatine Fossa Superior Orbital Fissure 
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  1. 1.
    Ashkenazi A, Blumenfeld A, Napchan U, Narouze S, Grosberg B, Nett R, DePalma T, Rosenthal B, Tepper S, Lipton RB, Interventional Procedures Special Interest Section of the American. Peripheral nerve blocks and trigger point injections in headache management- a systemic review and suggestions for future research. Headache. 2010;50:943–52.PubMedCrossRefGoogle Scholar
  2. 2.
    Blumenfeld A, Ashkenazi A, Napchan U, Bender SD, Ailani J, Klein B, Berliner R, Schim J, Friedman D, Charleston L, Young WB, Roberston CE, Dodick DW, Silberstein SD, Robbins MS. Recommendations for the performance of peripheral nerve blocks for headaches – a consensus statement from the American Headache Society Interventional Procedures Section. Headache. 2013;53:437–46.PubMedCrossRefGoogle Scholar
  3. 3.
    Groseth G, Cruccu G, Alksne J, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence based review); report of the American academy of Neurology and European Federation of Neurological societies. Neurology. 2008;71:1183–90.CrossRefGoogle Scholar
  4. 4.
    Narouze S. Head and neck blocks. In: Huntoon M, Benzon H, Narouze S, editors. Spinal injections and peripheral nerve blocks. 1st ed. Deer T (series editor) Interventional and neuromodulatory techniques for pain management. Saunders: Elsevier; 2011.Google Scholar
  5. 5.
    Narouze S. Complications of head and neck procedures. Tech Reg Anesth Pain Manag. 2007;11:171–7.CrossRefGoogle Scholar
  6. 6.
    Murphy T. Somatic blockade of head and neck. In: Cousins M, Bridenbaugh P, editors. Neural blockade in clinical anesthesia and management of pain. 3rd ed. Philadelphia: Lippincott-Raven; 1998. p. 489–514.Google Scholar
  7. 7.
    Herlich A. Focused local anesthesia and analgesia for head and neck surgery. Int Anesthesiol Clin. 2012;50:13–25.PubMedCrossRefGoogle Scholar
  8. 8.
    Rosenberg M, Phero JC. Regional anesthesia and invasive techniques to manage head and neck pain. Otolaryngol Clin North Am. 2003;36:1201–19.PubMedCrossRefGoogle Scholar
  9. 9.
    Rozen TD. Trigeminal neuralgia and glossopharyngeal neuralgia. Neurol Clin. 2004;22:185–206.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Center for Pain Medicine, Western Reserve HospitalCuyahoga FallsUSA

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