. 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. 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 j
. 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. 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 majority of cases taste fibersfrom the tongue reach the pons through the third division of the fifthnerve at the foramen ovale, and probably reach the otic ganglionthrough the small superficial petrosal from the geniculate ganglion on sG^. Fig. 238.—Instrumentarium for injection of gasserian ganglion (Windier, Berlin):a, Needle, 10 cm. long, mm. thick. Nickeled steel with short sharp point a^ andmovable gauge a-; b, fine needle for skin anesthesia; c, 2 record syringe; d, metalcentimeter measure (reduced). (Hartel.) the facial, thus continuing the carda tympani fibers serving taste sen-sation. In the minority of cases (15 per cent, in which taste is notaffected, there must be an alternative path in which cases it seemsprobable that taste sensations are continued from the geniculateganglion to the gustatory nucleus, in the medulla through the parsintermedia of Wrisberg. While these conclusions are not acceptedby all observers, they at least appear reasonable and are worthy ofreco
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