THE NASOLACRIMAL reflex (NLR) consists of lacrimation following chemical or mechanical stimulation of the nasal mucosa.
The trigeminal nerve (ophthalmic and maxillary branches) forms the afferent paths. Its efferent paths proceed from the superior salivary nucleus along the intermedius nerve, through the geniculate ganglion, the greater superficial petrosal nerve, and the nerve of the pterygoid canal to the sphenopalatine ganglion from which they continue through the sphenopalatine nerves to the maxillary nerve and via the zygomatic nerve to the lacrimal nerve and the lacrimal gland (Fig 1).
In the main, the pathway of the reflex was mapped by Wernöe16 in 1927. As early as 1900, however, Köster11 found that the secretomotor fibers to the lacrimal gland proceed along the above-mentioned course. That the reflex path takes this course is apparent from the following findings (Zilstorff-Pedersen18 1959):
In 15 cases of postoperative total peripheral facial palsy following removal
ZILSTORFF-PEDERSEN K. Quantitative Measurements of The Nasolacrimal Reflex: In the Normal and in Peripheral Facial Paralysis. Arch Otolaryngol. 1965;81(5):457–462. doi:10.1001/archotol.1965.00750050470003
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