Relation of Irritation in Region of Paranasal Sinuses to Certain Vasomotor Changes: An Experimental Study

Abstract

The problem of pain in the mastoid region, the neck, the base of the head and contiguous areas from infection in the region of the sphenopalatine ganglion has received much attention. There is no need to review the literature at the present time. Various explanations of this syndrome, called after Sluder, who first pointed it out clearly, have been offered by a number of students of the problem. In 1936 two of us,1 on the basis of anatomic and experimental considerations, offered the hypothesis that Sluder's syndrome is due to vasomotor changes in the areas of pain brought about by reflexes induced through irritation by sinus disease of the nerves in the region of the sphenopalatine ganglion. This hypothesis is based on the assumption that reflex ischemia is produced, giving rise to local impulses of pain. These are presumably transmitted to the central nervous system by the segmental cutaneous nerves of the region involved. The hypothesis was strengthened by the fact that human patients with typical symptoms were relieved of their pain by injection of procaine hydrochloride into the skin of the mastoid region. The nervous pathways thought to be involved are the nasal and the palatine branch of the sphenopalatine ganglion, the great superficial petrosal nerve, the connections within the medulla oblongata with the reticulospinal tract and, through those, the connections with From the

The Autonomic Nervous System

“…Huyghebaert (180), Larsell, Barnes & Fenton (226) and Kuntz (204) have dealt with the innervation of the nasal mucous mem brane. Kuntz believes that the nasal mucous membranes have a sensory innervation, the fibers of which arise from the dorsal root ganglia in the upper thoracic segments.…”

“…Thorn ton (354) found that stimulation of the phrenic nerve in the cat produced broncho-dilatation, the afferent pathway of which is in the phrenic and the efferent one in the vagi. The influence of afferent impulses from various portions of the respiratory tract upon the vasomotor apparatus has been studied (42,92,154,226,321). Bolton and his coworkers have shown that, when deep breathing occurs in man, there is a diminution of finger volume.…”