56 TRIFACIAL NEUROTOMY. 



twigs which are directed upward near the foramen. After 

 the hemorrhage has been brought under complete control 

 and all blood clots have been removed cleanse the wound 

 carefully and dust over with iodoform and close with con- 

 tinuous sutures. Owing to the great difficulty of securing 

 complete asepsis, it may be better in some cases to not suture 

 but to insert instead an antiseptic tampon retained by sut- 

 ures for 24 hrs. after which remove and dress the wound 

 antiseptically 2 or 3 times daily. In order to protect this 

 first wound during the operation upon the other side take 

 the piece of muslin mentioned among the needs for the 

 operation, and folding it several times in a square, place it 

 .over the wound and suture it firmly at each corner. Turn 

 the animal to the opposite side and repeat the operation on 

 the other nerve except the application of the square piece 

 of muslin which is here unnecessary. As soon as the aaimal 

 stands, remove the protective piece of muslin from the first 

 wound, disinfect both, dust them over with iodoform and 

 tannin or cover with wound gelatine and leave undisturbed 

 to heal by primary union. Avoid halter, bridle or other 

 fixtures which might injure the wounds after the operation. 



Dangers. The chief danger in the operation is from in- 

 fection, which sets up a .severe neuritis in the proximal end 

 of the nerve, aggravates the symptoms and causes much 

 suffering. In order to prevent infection the aseptic precau- 

 tions need be unusually strict in every detail and the anaes- 

 thesia profound. Carefully avoid wounding the neighbor- 

 ing vessels and control completely any hemorrhage that 

 occurs in order to avoid a hematom in the wound, which 

 would invite infection. 



Literature. Involuntary twitching of the head relieved 

 by trifacial neurectomy. W. ly. Williams, Jour. Comp. 

 Med. and V. A., vol. XVIII, p. 426. Involuntary shaking 

 of the head and its treatment by trifacial neurectomy, do. 

 Am. Vet. Rev., vol. XXIII, p. 321 and CEst. Monatsch. 

 Thierheilkunde, Bd. XXIV, s. 211. 



