On facial neuralgia and its treatment : with especial reference to the surgery of the 5th nerve and the Gasserian ganglion / by J. Hutchinson.

  • Hutchinson, Jonathan, 1859-1933.
Date:
1919
Catalogue details

Licence: In copyright

Credit: On facial neuralgia and its treatment : with especial reference to the surgery of the 5th nerve and the Gasserian ganglion / by J. Hutchinson. Source: Wellcome Collection.

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    4 petrous bone, lying beneath and in the same sheath as the sensory root. Ouain states that “after leaving the cranial cavity by the foramen ovale it joins the sensory part of the mandibular nerve.” From this one would infer that inside the skull the motor and sensory parts remain distinct, but repeated dissection has convinced me that this is not the case. The motor root when beneath the ganglion is so intimately blended with the latter that it is rarely possible to distinguish or isolate the former. It is obvious that if the motor root could be separated and spared whilst the sensory part were divided, some advantage would be gained, as the muscles of mastication on that side would retain their power. Several surgeons have claimed to have done this (e.g., Frazier and Spiller1 Jaboulay and Cavaillon).2 The only possible method of performing this delicate isolation of the sensory root from the motor one consists in opening the dura above the ganglion and cutting through the sensory part there, leaving the ganglion intact. The difficulties are great in securing this isolated division of the sensory root, and Delbet and Chevason3 in a recent review of the subject 1 Frazier and Spiller, Philad. Med. Journ., October 25, 1902, t alia. 2 Jaboulay and Cavaillon, Lyon Medicate, June 14, 1908. 3 Delbet and Chevason, “ Affections Chirurgicales de la Face,” 1911, p. 319.