. 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. 183.—Needle in position in Matas intra-orbital injection within foramen rotundum. (Braun.) just below the floor of the orbit, and that if this plane were used as ameans of reaching it, the needle, if directed toward the apex of theorbit medially along the floor, would pass into the superior orbital 554 LOCAL ANESTHESIA fissure, and meeting no bony resista
. 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. 183.—Needle in position in Matas intra-orbital injection within foramen rotundum. (Braun.) just below the floor of the orbit, and that if this plane were used as ameans of reaching it, the needle, if directed toward the apex of theorbit medially along the floor, would pass into the superior orbital 554 LOCAL ANESTHESIA fissure, and meeting no bony resistance here may, if advanced too far,pass backward into the cranial cavity. This route is discussed byHartel (Fig. 184). This would seem a more dangerous route, and not likely to lead tothe foramen rotundum, but above it. The original route, as advocated by Prof. Matas, traverses the or-. Fig. 184.—Horizontal section of left half of skull in lower horizontal orbital plane,seen from above, with needle in foramen rotundum: i, Infra-orbital sulcus; 2, zygomati-co-maxillary suture; 2, infra-orbital fissure; 4, foramen rotundum; 5, foramen ovale.(Hartel.) bit for but a short distance, as the needle soon passes out of this cavityinto the sphenomaxillary fissure (Figs. 182, 183). If the sphenomaxillary fissures are observed, they will be seen torun at right angles to each other and about on a horizontal plane;their axes if continued back would meet over the body of the sphenoidbone, and if projected forward would emerge at the inferior externalangle of the orbit; also, that the axis of this fissure, if raised to aslightly elevated plane, would pass through the orbital foramen orsuperior orbital fissure at the apex of the orbit. The axis of the foramen rotundum, if viewed from within the THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 555 skull, passes downward, forward, and outwa
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