. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. ribes an outwardly convex curve. Let us now follow the way further into the skull. For the ac-curate puncture of the ganglion Gasseri we have established therequirement of adherence to the so-called axis of the trigeminus; thatis, a straight Line going from the middle of the impressio trigemini 538 LOCAL ANESTHESIA of the petrous portion of the temporal bo
. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. ribes an outwardly convex curve. Let us now follow the way further into the skull. For the ac-curate puncture of the ganglion Gasseri we have established therequirement of adherence to the so-called axis of the trigeminus; thatis, a straight Line going from the middle of the impressio trigemini 538 LOCAL ANESTHESIA of the petrous portion of the temporal bone through the middle of theforamen ovale (Figs. 199, 200). Only a cannula introduced into theskull in this direction avoids collateral injuries of the tissues adja-cent to the cavum Meckeli (Figs. 207, 208), namely, of the sinuscavernosus, of the carotis interna, of the sinus petrosus superior, andof the brain. If, as we have said above, the foramen ovale is not asimple hole, but forms a bone-canal about 1 cm. long, so we rind nowthat the long axis of this canal corresponds to this axis of the trigemi-nus; in other words, passes parallel to the anterior surface of thepyramid of the petrous portion of the temporal bone (Fig. 201); if. Fig. 200.—Same as Fig. 199, seen from the side, showing needle passing into foramen ovalebetween ascending ramus of lower jaw and maxillary tubercle. (Hartel.) it should not do this, and, for example, should pass more steeply (, b), then the cannula would penetrate, not into the ganglion, butthrough the dura into the temporal lobe; if it passes more on a level,then the danger exists that the cannula from above, through the fora-men lacerum, may prick the carotis interna. The latter situationwe never found; the former, less dangerous, situation, very seldom (3times in 114 examinations); and even in these cases of incongruencebetween the inclination of the pyramid of the petrous portion of thetemporal bone and the long axis of the canal of
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
