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In the February, 1925, issue of the Laryngoscope I reported a classical case of tic doloureux, which was relieved by injection of the nasal ganglion through the palatomaxillary canal route, which treatment I advocate. Since that time, I have found this method of injection successful also for trigeminal neuralgia.
The palatomaxillary canal route which I have described, has the great advantage of reaching not only the nasal ganglion, but also the maxillary division of the trigeminal nerve. Tic doloureux appears to be an involvement of both the sensory trigeminal fifth nerve and the motor facial seventh nerve. Not only is there pain along the mandibular, maxillary and ophthalmic branches of the trigeminal, but also synchronous with the pain there is a spasm of the face muscles innervated by the seventh nerve. An impulse giving such a double stimulus would necessarily have to strike both nerve systems at a common junction.