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Abstract In this study The SMN block was done by a blind technique according to landmarks ; this may explain the decreased efficacy compared to the GPN block. Safety and feasibility of the block can be increased by using a nerve stimulator, which could stimulate the temporal muscle. The pterygopalatine fossa is situated just behind the muscle; disappearance of the muscular response to direct stimulation with the block needle indicates its tip is in the infratemporal fossa. The pterygopalatine fossa could also be localized with ultrasound guidance. Moreover, the use of ultrasound imaging may be useful if the distance between skin and pterygomaxillary fossa were slightly modified by the presence of the cleft palate |