Operative surgery . ed in the pro-cedure are essential of the pleura and im-2:)ortant vessels and nerves is to beavoided. Be not too confident ofa favorable therapeutic outcome. The Bern arks. — Jonnesco re-gards apjiroaeh to the nerve bysplitting the posterior border of the sterno-mastoid muscle as less trouble-some than exposure of and passing under the border. The superior ganglionis the largest of the three, is located opposite the second and third cervicalvertebrae, sometimes as low as the fourth or fifth. It lies behind the sheathof the carotid and upon the rectu
Operative surgery . ed in the pro-cedure are essential of the pleura and im-2:)ortant vessels and nerves is to beavoided. Be not too confident ofa favorable therapeutic outcome. The Bern arks. — Jonnesco re-gards apjiroaeh to the nerve bysplitting the posterior border of the sterno-mastoid muscle as less trouble-some than exposure of and passing under the border. The superior ganglionis the largest of the three, is located opposite the second and third cervicalvertebrae, sometimes as low as the fourth or fifth. It lies behind the sheathof the carotid and upon the rectus capitus anticus major muscle. The mid-dle ganglion is the smallest of the three and is sometimes wanting. It islocated opposite the sixth cervical vertebrae, is closely associated with theinferior thyroid artery, hence denominated thyroid ganglion. The inferiorcervical ganglion is situated between the base of the transverse process ofthe last cervical vertebra and the neck of the first rib at the inner aspect of. Fig. 155:1—The middle cervical ganglion ofcervical sympathetic nerve, a. Commoncarotid artery in sheath, h. Pneumogas-tric nerve in sheath, c. Internarl jugularvein in sheath, d. Sympathetic Inferior thyroid artery. /. Middle cer-vical ganglion, g. Vertebral vein. anticus muscle, i. Thyroid axis, MiSCKLLANHors OIKKATIONS. 1285 tlie siijxM-ior intoreoslal iirtory. It is next iu size to the superior inferior ganglion usuully lies inside the vertebral artery and invests thisvessel with its biaiiclies. Sometimes this ganglion is friable and removedpiecemeal. The licsnlts.—Juidicsco reports the following outcome secured bv him-self and others in this o])eration : 1. Simple incision has been done by Jaboulay three times with good opera-tive results, but the possibility of regeneration at the seat of division makesthis method of practice untrustworthy. i. Partial Resection.—All the nerves down to the thyroid artery and thesuperior g
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