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Vazirani-Akinosi for Trismus — NDEB AFK MCQ

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ModeratePain & Anxiety ControlVazirani-Akinosi for TrismusNDEB AFK

A patient with severe trismus from a dental infection has a maximum inter-incisal opening of 15 mm. Which nerve block technique is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Vazirani-Akinosi closed-mouth technique (can be performed with minimal or no mouth opening)

The Vazirani-Akinosi technique is specifically designed for patients who cannot open adequately for conventional nerve blocks. It is performed with the mouth closed — the needle is inserted medial to the ramus at the level of the maxillary mucogingival junction (above the maxillary molar occlusal plane), directed posteriorly parallel to the maxillary occlusal plane. The anaesthetic is deposited in the pterygomandibular space, anaesthetising the IAN, lingual nerve, and mylohyoid nerve simultaneously. It is the technique of choice for patients with trismus from infection, fracture, or TMD.

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020