. Manual of operative surgery. was obtained. Instead of using the spinal accessory, the hypoglossal nerve has been utilizedto supply nerve stimuli to the facial. This was first done by Ballance andStewart, later by Frazier. The glossopharyngeal nerve has also been similarlyused. The various operations for facial palsy may be systematized as follows: Anatomy.—The facial nerve emerges through the stylo-mastoid foramenwhere it is deeply seated; from here it runs downwards, outwards and alittle forwards to turn or wind round the styloid process, after this its courseis almost horizontally forwards
. Manual of operative surgery. was obtained. Instead of using the spinal accessory, the hypoglossal nerve has been utilizedto supply nerve stimuli to the facial. This was first done by Ballance andStewart, later by Frazier. The glossopharyngeal nerve has also been similarlyused. The various operations for facial palsy may be systematized as follows: Anatomy.—The facial nerve emerges through the stylo-mastoid foramenwhere it is deeply seated; from here it runs downwards, outwards and alittle forwards to turn or wind round the styloid process, after this its courseis almost horizontally forwards until it crosses the posterior auricular arteryand immediately plunges into the parotid gland. The horizontal portion NERVE ANASTOMOSIS 791 of the nerve is situated at the level of the tip of the lobule of the ear, , about^i inch below the lower border of the zygomatic arch. The Spinal Accessory Nerve.~The external, spinal or surgical portion ofthis nerve emerges from the skull through the jugular foramen; from here it. Fig. 945.—Nerve anastomosis. {Cushing, Annals of Surg.) passes downwards, outwards and a little backwards in front of (rarely behind)the internal jugular vein between that vein and the occipital artery whichcrosses it perpendicularly. The nerve now lies exactly between the transverseprocess of the atlas and the posterior border of the digastric. Below this point 792 NERVES the nerve passes behind the posterior border of the parotid to enter the deepsurface of the sterno-mastoid 2 inches below the apex of the mastoid process. The Hypoglossal Nerve.—The hypoglossal nerve leaves the skull throughthe anterior condylar foramen and lies on the inner side of the deep cervicalvessels. As it descends, the nerve comes forward between the internal carotidartery and jugular veins to the lower border of the digastric muscle where itcurves forwards round the origin of the occipital artery, the sterno-mastoidbranch of which turns downwards over the nerve. From this
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