The practice of surgery . lla and malarbone is severed. By the same instrument the alveolar process is cutthrough, at the part exposed by the labial wound ; and a groove is alsomade in the palatine process, at the part incised. A pair of stout andlong bone-pliers may then be used to complete the section at this part;one blade resting in the palatine and alveolar groove, the other passedinto the corresponding nostril. If such an instrument be not at hand,however, the section may be completed readily enough by means of thesaw alone. The nasal process is severed by the ordinary cutting
The practice of surgery . lla and malarbone is severed. By the same instrument the alveolar process is cutthrough, at the part exposed by the labial wound ; and a groove is alsomade in the palatine process, at the part incised. A pair of stout andlong bone-pliers may then be used to complete the section at this part;one blade resting in the palatine and alveolar groove, the other passedinto the corresponding nostril. If such an instrument be not at hand,however, the section may be completed readily enough by means of thesaw alone. The nasal process is severed by the ordinary cutting , now, by pressing the tumor downwards, it is dislodged from itsconnections ; while complete separation is readily effected by touchingwith the knife those soft parts which require its edge. The velum ofthe palate, formerly separated, is carefully preserved—and, if possible,also the palatine plate of the palate bone. One or two vessels, hang-ing in the deep wound, will probably require ligature ; and the facial Fig. Portrait after rcmoral of the Upper Jaw, for Osteosarcoma. An example of how little deformity may in some cases remain. vessels, which during the operation were restrained by the fingers of anassistant, are also secured. The amount of deep bleeding is often butslight; the vessels being torn, not cut, during evulsion of the tumor. 184 EXTIRPATION OF THE SUPERIOR MAXILLA. The vacant space, having been cleared of coagulum, is filled with lint;and over this the flap is replaced. Both incisions are then broughttogether with great accuracy, by means of the twisted and interruptedforms of suture ; treatment is conducted for adhesion ; arTd, generally,this does not fail to occur, in almost the entire extent of the facialwound. The deep cavity of course inflames and suppurates. The lintloosens, and is brought away. A less amount of dressing is daily re-newed, medicated with a weak solution of the chlorides ; granulationadvances, and cicatrization is in due time obtain
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