. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. Fig. 163.—Regional anesthesia by way of infra-orbital foramen. (After Fischer.) r^ i 1 I: Li- Fig. 164.— Resulting area of anesthesia after bin kint; both infra-orbital nerves at infra-foramen. (Braun.) of the fifth nerve are involved in the field of operation it is alwayspreferable to block the gasserian ganglion when possible, but for 534 LOCAL ANESTHESL^ va
. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. Fig. 163.—Regional anesthesia by way of infra-orbital foramen. (After Fischer.) r^ i 1 I: Li- Fig. 164.— Resulting area of anesthesia after bin kint; both infra-orbital nerves at infra-foramen. (Braun.) of the fifth nerve are involved in the field of operation it is alwayspreferable to block the gasserian ganglion when possible, but for 534 LOCAL ANESTHESL^ various reasons this may not be feasible we must then have alterna-tive measures such as above. In operations within the mouth which are not readily accessible,as in lesions far back on the tongue, cheek wall, pillars of the pharynx,etc., we often slit the cheek back to the ramus of the jaw, thus securing. Post. sup. dental nn. Infra-orbital nn Post. sup. dental nn. Incisors an 1 Bicuspids Middle superior dental Fig. 165.—Areas of nerve supply of maxilla. Oblique shading: anterior superiordental nerves (incisor and canine region). Horizontal shading: middle superior dentalnerve (bicuspid region); vertical shading: posterior superior dental nerves (molarregion). (After Fischer.) greater room and freer access for work on these deeper parts. Suchincisions in the cheek, when properly closed, leave simply a linearscar. For the areas of distribution of the branches of the fifth nerveto the maxillae, teeth, gums, and hard palate see Figs. 165-168, whilethe points of emergence of the peripheral branches uj)on the face THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE Nasopaliiline notch 535 Anastomosis between anteriorpalatine and nasopalatine
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