. 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. se so frequently met with inthis region, the superior maxillary nerve may first be blocked by theMatas intra-orbital or one of the lateral routes. The Peuckart medialpuncture of the orbit may now be used to control the nasal nerve andits branches on the inner side of the lower fid and upper inner angleof the face; if a wall of anesthesia is now carried dow
. 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. se so frequently met with inthis region, the superior maxillary nerve may first be blocked by theMatas intra-orbital or one of the lateral routes. The Peuckart medialpuncture of the orbit may now be used to control the nasal nerve andits branches on the inner side of the lower fid and upper inner angleof the face; if a wall of anesthesia is now carried down from the malarprominence to below the line of the mouth, and made well down intothe subcutaneous tissues, it will effectively control the malar, masse-teric, and buccinator nerves. If the field is below the line of the mouth the inferior dental ormental nerve may be blocked at their respective foramina, and the 490 LOCAL ANESTHESIA cervical nerves controlled by a subcutaneous line of infiltration overthe lower border of the inferior maxilla. For the areas of distribution of the branches of the fifth nerveto the maxillae, teeth, gums, and hard palate see Figs. 160-163,while the points of emergence of the peripheral branches upon the. Fig. 157.—The supra-orbital foramen is located at the junction of the inner and middlethirds of the supra-orbital margin; a line drawn from this point, passing between the twobicuspids of the upper and lower jaw, should pass over the infra-orbital and mentalforamina. (After Sobotta and McMurrich.) face and head is shown in Fig. 142. A study of this figure will provevery useful for operations upon the peripheral soft parts. For theinnervation of the mucous passages and accessory sinuses a study ofFig. 191 will be found very useful. Operations upon the peripheral ends of the fifth nerve can be easilydone, as in resections for neuralgia. The foramina are first exposed THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 491 by an incision and an injection of
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