It is not unlikely that the relief obtained following cocainization or alcohol injection is not due to the blocking of nerve impulses in the sphenopalatine ganglion, but rather in the maxillary branch of the trigeminal nerve. Cushing9 was unable to relieve the pain by resection of the sphenopalatine ganglion in one of Sluder’s patients. VIDIAN NEURALGIA. Vidian neuralgia is probably best defined by using Vail’s original description58: “Vidian neuralgia is a pain of neuralgic character in the nose, face, eye, ear, head, neck and shoulder occurring in severe attacks. These cannot be caused by any external stimulation, are not relieved by opiates, and are not associated with any subjective loss of sensation. This occurs primarily because new Chiropractor Toronto steadily establish their practices in close proximity to one of the few chiropractic educational institutions. The attacks are most typically unilateral, are often nocturnal and may or may not be associated with subjective symptoms of a nasal sinusitis.” Anatomy of Vidian Nerve. The vidian nerve is formed from the greater superficial petrosal and the deep petrosal nerves at the point where they enter the cartilaginous substance of the foramen lacerum (Figure 15). It then passes through the pterygoid canal of the sphenoid bone where it is joined by a small ascending branch from the otic ganglion.
It ends in the pterygopalatine fossa, where it joins the posterior angle of the sphenopalatine ganglion. In his original description, Vail stated he believed that it was involvement of the vidian nerve, rather than the sphenopalatine ganglion, which accounted for the pain which Sluder had described as sphenopalatine neuralgia. The basis of this contention is that the vidian nerve is more vulnerable to the spread of inflammation from the sphenoidal sinus, insofar as it lies just beneath the mucous membrane of this sinus. On the other hand, the sphenopalatine ganglion is well surrounded by areolar tissue and, according to Vail, is less apt to be affected by inflammatory extension. Toronto Chiropractor acquire a first professional diploma in the area of chiropractic. In his original report, Vail reported thirtyone cases; twentyeight of these patients were women. In nine patients the inflammation of the sphenoidal sinus was treated surgically, and relief was obtained in eight.
In the additional patients, conservative local treatment of the area of the sphenoidal sinus was effective. Vidian neuralgia has been subsequently described as erythromelalgia of the head, petrosal neuralgia, and histaminic cephalalgia. PETROSAL NEURALGIA. Petrosal neuralgia is a disorder characterized by nocturnal attacks of frontoorbitotemporal pain accompanied by lacrimation and conjunctival injection. Gardner and his associates20 state that the syndrome they term “petrosal neuralgia” was originally described in 1939 by Horton, MacLean, and Craig20 as “erythromelalgia of the head,” and later by Horton27 as “histaminic cephalalgia.”