. Text-book of operative surgery . s of temporal resection. In inflammatory conditions of the orbitan osteoplastic Operation is not indicated. We are not aware of any Operation having been performed on the oculo-motor andtrochlear nerves. On the other band, the fifth cranial nerve (trigeminal) and itsbranches are dealt Avith surgically for the treatment of neuralgia. Before the introduction of the intracranial Operation of excision of the Gasserianganglion or its root, the divisions of the trigeminal nerve were severed as near as 2l8 OPERATIVE SURGERY possible to the base of the skull. But alt
. Text-book of operative surgery . s of temporal resection. In inflammatory conditions of the orbitan osteoplastic Operation is not indicated. We are not aware of any Operation having been performed on the oculo-motor andtrochlear nerves. On the other band, the fifth cranial nerve (trigeminal) and itsbranches are dealt Avith surgically for the treatment of neuralgia. Before the introduction of the intracranial Operation of excision of the Gasserianganglion or its root, the divisions of the trigeminal nerve were severed as near as 2l8 OPERATIVE SURGERY possible to the base of the skull. But altliough the second and third divisions couldbe divided in this way, section of the first division was impracticable. Division of the peripheral branches of the trigeminal is at the present tiniepractised more frequently than the intracranial Operation, because in neurexeresis(Thiersch) a much more effective method of treatment has been found than that ofsimple neurotomy. It was devised as a result of van Gehuchtens histological and. FrontalSinus. Orbicularis 1 palp. 111. j Levator labii) superioris. j Infraorbital n. Fig. 103.—Ligature of tlie siipraorbital arterj-. Exposure of tlie supraorbital nerve. Opening of the frontal simis. experimental work. Only a limited portion of a nerve requires to be exposed, afterAvhich it is seized with strong forceps, tmsted, and torn out both from its central andperipheral connections. According to van Gebuchten, wheu the nerve is partly tornout instead of being simply divided, a greater effect is produced on the centralganglion cells, more especially on those in the Gasserian ganglion, and in the sensoryroot to the bulbospinal centres. The method whicli Blum tirst practised on the infra-orbital nerve gives the greatest certainty of success, while, as no extensive preliminarjdissection is required, the Operation is greatly simplified. In the following sections SURGERY OF INDIVIDUAL PERIPHERAL XERVES 219 we therefore descri
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