A manual of operative surgery . the disc isremoved by means of theelevator. It is almost cer-tain that the groove con-taining the inferior dentalnerve and vessels will beopened thereby, and itshould very carefully becleared on either side witha small chisel or bone-cutting forceps. The grooveshould be followed upwardsand downwards, with duecaution not to injure the inferior dental artery, until the nerve can be raised alone on a Thierschs forceps a long piece of both ends of the dividednerve can sometimes be drawn out ; if not, as much should becut away as possible. The bone disc nee
A manual of operative surgery . the disc isremoved by means of theelevator. It is almost cer-tain that the groove con-taining the inferior dentalnerve and vessels will beopened thereby, and itshould very carefully becleared on either side witha small chisel or bone-cutting forceps. The grooveshould be followed upwardsand downwards, with duecaution not to injure the inferior dental artery, until the nerve can be raised alone on a Thierschs forceps a long piece of both ends of the dividednerve can sometimes be drawn out ; if not, as much should becut away as possible. The bone disc need not be replaced, and twoor three fine sutures will suffice for the wound, which heals patient should be kept on liquid or soft food for a few days. The success of the operation depends chiefly on exactly followingthe landmarks given, and avoiding injury to the companion a rule, the dental nerve lies just in front of the latter, and is readilydistinguished, once the canal is opened, by its whiter A, FIG. 231.—DISSECTION OF THE THIRD DIVISION OF THE FIFTH nerve. [Elliss Dissections.) Temporal muscle ; B, Condyle of jaw ; C,Internal pterygoid muscle ; D, Buccinator ; E,Masseter ; F, Internal lateral ligament; a, In-ternal maxillary artery; i, Buccal nerve; 2,Masseteric nerve; 3, Temporal nerve; 4, Auri-culo-temporal nerve ; 5, Inferior dental nerve ;6, Lina;ual nerve. 94 OPERATIONS ON HEAD AND NECK [part hi After this neurectomy the pain is, as a rule, entirely absent forone, two, or more years, but it is exceptional for no recurrence of anykind to be experienced. It may be noted that immediately after theoperation, for a few days, the patient will complain of aching, due tothe traction of the proximal end. OPERATIONS UPON THE FACIAL NERVE These are of two kinds : in one the nerve is stretched for therelief of spasmodic tic, in the other the paralysed nerve is anas-tomosed with a near-lying cranial nerve in the treatment of per-sistent facial par
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