A manual of operative surgery . cover of the exter IKV^ ^^wM na* Pteryg°id mus- cle, passes to theouter side of theinternal pterygoid, and running be-I • tween the internal —THIRD DIVISION OF THE FIFTH NERVE. _. {After Hirschfeld and Leveille.) °1, Masseteric nerve; 2, Posterior temporal nerve; 3, Buccal *-^e ramus 01 tnenerve; 4, Branch to facial nerve; 5, Anterior temporal iaw enters the den-nerve ; 6, Middle temporal nerve; 7, Auriculo-temporal J .nerve; 8, Its temporal branches; 9, Inferior dental nerve; tal foramen (, Mylo-hyoid nerve; 11, Gustatory nerve; 12, Facial oor. QTlri OOT
A manual of operative surgery . cover of the exter IKV^ ^^wM na* Pteryg°id mus- cle, passes to theouter side of theinternal pterygoid, and running be-I • tween the internal —THIRD DIVISION OF THE FIFTH NERVE. _. {After Hirschfeld and Leveille.) °1, Masseteric nerve; 2, Posterior temporal nerve; 3, Buccal *-^e ramus 01 tnenerve; 4, Branch to facial nerve; 5, Anterior temporal iaw enters the den-nerve ; 6, Middle temporal nerve; 7, Auriculo-temporal J .nerve; 8, Its temporal branches; 9, Inferior dental nerve; tal foramen (, Mylo-hyoid nerve; 11, Gustatory nerve; 12, Facial oor. QTlri OOTerve. ^5> d-nu z5Ll- This foramen issurmounted by a prominent and usually sharp projection of bone,the lingula or spine of Spix. To its apex is attached the internallateral ligament of the jaw, while below and behind it is the groovefor the mylo-hyoid nerve. The internal pterygoid muscle reaches to the base of the lingula. The nerve is accompanied by the inferior dental artery, which liesbehind and externally to FIG. 230. CHAP. Ill INFERIOR DENTAL NERVE 93 -B Neurectomy of the Inferior Dental Nerve through a Trephine Aper-ture in the Lower Jaw.—The point of bone to be aimed at is indicatedon the ascending ramus by the meeting of two lines—one perpendicularto the lower border of the jaw passing upwards from its angle, theother a continuation backwards of the alveolar margin (Fig. 222).This point on the side of the cheek is well below the parotid duct andbehind the facial vein ; the skin incision of one inch should be mainlyhorizontal, to avoid injury to the facial nerve, but it is convenient tocurve it slightly. The masseter being exposed, its fibres are partlysevered, but chiefly separ-ated, until the bone isreached and bared with aperiosteal elevator. The pin of a small(half-inch) trephine is theninserted exactly at the spotabove-mentioned, and whenthe outer table of compactbone is traversed the disc isremoved by means of theelevator. It is almost cer-tain th
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Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
