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.

    33/276 (page 9)
    inferior maxillary trunk a few millimetres in front and internal to the former, and finally follows up the superior maxillary trunk to the foramen rotundum, a centimetre or more in front and at a slightly higher plane. In this way the whole lower edge of the ganglion and its two chief trunks are exposed. It may be thought that such precise directions are needless, but experience teaches that when operating it is essential to keep in one's mind the exact relative position of the foramina referred to, and it is certain that many operators have failed in the attempt to make out the ganglion at all. The external landmarks are discussed in another chapter ; it may be noted here that the pre-glenoid tubercle at the root of the zygoma is exactly opposite the foramen ovale, separated by a distance of four centimetres. Both the foramina ovale and rotundum are really canals with bony walls rather than mere apertures in the bone, this is especially marked in the case of the rotundum—moreover the superior maxillary nerve before entering this canal frequently rests in a deep groove in the body of the sphenoid. This is of especial interest with regard to the cavernous sinus, injury to which during operation on the ganglion has been sometimes the cause of serious trouble, or even of a fatal result. The ganglion itself is in contact by its deep aspect in front with the outer wall of the sinus, the superior maxillary division lies against the