. 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. Fig. 17S.—Needle in position in Matas intra-orbital injection within foramen rotundum. (Braun.) sphenomaxillary fossa, and for a short distance through the spheno-maxillary fissure, and emerge upon the rim of the orbit just internal 5 LOCAL ANESTHESIA to its inferior external angle, at a distance of from 4 to 5 cm., varyingsomewhat in different skulls. It
. 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. Fig. 17S.—Needle in position in Matas intra-orbital injection within foramen rotundum. (Braun.) sphenomaxillary fossa, and for a short distance through the spheno-maxillary fissure, and emerge upon the rim of the orbit just internal 5 LOCAL ANESTHESIA to its inferior external angle, at a distance of from 4 to 5 cm., varyingsomewhat in different skulls. It will be seen from the above that undoubtedly the safest method,as well as the surest of approach to the foramen rotundum is by theMatas route, for if a plane above this route is taken the needle maypass on without resistance into the cranial cavity, but if the route isfollowed by passing through the sphenomaxillary fissure that theneedle-point impinges upon the body of the sphenoid bone, on the. Fig. 170.—Horizontal section of left half of skull in lower horizontal orbital plane,seen from above, with needle in foramen rotundum: I, Infra-orbital sulcus; 2, zygomatico-maxillary suture; 2, infra-orbital fissure; 4, foramen rotundum; 5, foramen ovale.(Hartel.) posterior surface of the sphenomaxillary fossa; and if unable to enterthe foramen rotundum through insufficient play of the needle, due tothe narrowing of the sphenomaxillary fissure, is at least in immediatecontact with the nerve; but, if after reaching the posterior wall of thefossa the foramen is felt for, by gentle manipulation immediately aroundthe axis of the needle, the foramen may often be entered, when theneedle may be advanced a few millimeters further and the injectionmade. THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 513 The proof of contact of the needle with the nerve is recognizedby the radiating pains along the branches of this nerve, felt on thecheek, in the upper teeth, and in the nose. Having reached with
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