THE SUPERIOR MAXILLARY REGION. 45 



SURGICAL ANATOMY OF THE SUPERIOR MAXIL- 

 LARY REGION. 



This region may be regarded as that occupied by the 

 superior maxilla and the tissues covering it. The 

 superior maxilla is a bone of great surgical interest, on 

 account of the many diseases to which it is liable ; hence 

 its position, relations, and connections are of the highest 

 practical importance. 



The structures exposed in their order on dissecting down 

 upon the superior maxilla are the skin and superficial 

 fascia ; the lower fibres of the orbicularis palpebrarum ; 

 the facial and infra-orbital vessels and nerves ; the zygo- 

 matici and the levator labii superioris; Steno's duct; 

 the transverse facial artery ; the buccal vessels and 

 nerves ; lymphatics, and the buccinator muscle. In the 

 hollow between the anterior border of the masseter and 

 the buccinator muscle is a large quantity of fat and 

 cellular tissue, which contributes, either by its excess or 

 deficiency, to the general contour of the face. 



Articulations of the Superior Maxilla. Articulating 

 with its fellow, it forms the whole of the upper jaw ; be- 

 sides this, it articulates with the frontal, ethmoid, nasal, 

 inferior turbinated, palate, vomer, malar, and lachrymal. 

 The sutures it forms with those bones which enter into 

 the formation of the face are very strong and difficult to 

 separate, so much so, that in excision it will generally 

 be found more satisfactory to divide it or its associate 

 near to the articulation than to attempt to wrench them 

 apart at the sutures. The processes requiring division 

 in its extirpation are the palatine, nasal, and malar. 

 Each bone assists in the formation of three cavities, the 

 mouth, nose, and orbit ; of two fossae, the zygomatic and 



