. 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. of the nasalmucous membranes, but on thecontrary the vomiting reflex ofthe pharynx does not. Theaccessory cavities of the noseare likewise anesthetic. Rad-ical operations of empyemasof the antrum of Highmoreare feasible with unilateralganglion anesthesia. For theethmoid cavity double anesthesia is always to be recommended(Fig. 198). Observations concerning the
. 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. of the nasalmucous membranes, but on thecontrary the vomiting reflex ofthe pharynx does not. Theaccessory cavities of the noseare likewise anesthetic. Rad-ical operations of empyemasof the antrum of Highmoreare feasible with unilateralganglion anesthesia. For theethmoid cavity double anesthesia is always to be recommended(Fig. 198). Observations concerning the sphenoid sinus and thehypophysis are not available. In the oral cavity complete anesthesia of the teeth, jaws and hardpalate can be depended upon. The soft palate usually receivesfibers from the glossopharyngeal plexus and consequently may retainsome sensation. The anterior two-thirds of the tongue normallybelong to the fifth nerve (Fig. 237) but this cannot be invariablybe depended upon as both sensory and taste fibers seem subject tosome variation. Hartel thinks that often sensory fibers are receivedthrough the carda tympani, which communicates with the seventh,thence to the fifth and through it to the glossopharyngeal. It is. Fig. 237.—Sensory innervation of thetongue: i and 2, Vagus nerve (dotted); 3and 5, glossopharyngeus (oblique lines); 4,and 6, lingual nerve (horizontal lines).(After Zander and Spalteholz.) THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 621 therefore safer in blocking the anterior part of the tongue to injectthe lingual nerve at the inner side of the ramus of the jaw, and formore extensive resections the technic as described on page 537 can befollowed. Regarding the sense of taste, Harris has found it to be ab-sent in 85 per cent, of cases of ganglion or third division injection andthat it comes on immediately and is coincident with anesthesia, ex-tending as far back as the circumvallate papillae. He consequentlydraws the conclusion that in the large majo
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