Ultrasound-Assisted Auriculotemporal Nerve Block for Temporomandibular Joint Minimally Invasive Procedures: A...

This technical note describes an ultrasound-assisted auriculotemporal nerve (ATN) block for minimally invasive temporomandibular joint procedures. To our knowledge, this is the first report of an ultrasound-mapped, skin-marking technique that maintains a perpendicular needle trajectory. The approach aims to improve precision and safety versus blind landmark injections while remaining less complex than fully in-plane methods. A linear probe mapped anatomy, and color Doppler confirmed the transverse facial artery. Crossed skin markings defined an extracapsular entry point. After antisepsis, a 22-gauge needle was advanced along the planned path, with incremental anesthetic injection and negative aspiration. Clinical feasibility was illustrated in a patient with temporomandibular joint osteoarthritis and arthralgia undergoing ATN block followed by arthrocentesis and intra-articular injections. Anatomical validation was performed in a fresh-frozen cadaver head using bilateral methylene blue injection and layered dissection to confirm perineural spread adjacent to the ATN without staining of the joint space or nearby neurovascular structures.