The diseases of the ear and their treatment . which it has been placed. In Blakes snare the tube is closed at its end, and is furnishedwith two orifices for the wire. In the instrument represented inFig. 40, the tube is open, and flattened at its end, so that the twobranches of the loop lie in the two angles thus formed. (The sameinstrument, furnished with other tubular pieces for fixing to the rod,can be used for operating upon nasal polypi and adenoid vegeta-tions in the naso-pharynx.) The tube being open, the loop can becompletely withdrawn into it, so that even polypi of greater consis-ten
The diseases of the ear and their treatment . which it has been placed. In Blakes snare the tube is closed at its end, and is furnishedwith two orifices for the wire. In the instrument represented inFig. 40, the tube is open, and flattened at its end, so that the twobranches of the loop lie in the two angles thus formed. (The sameinstrument, furnished with other tubular pieces for fixing to the rod,can be used for operating upon nasal polypi and adenoid vegeta-tions in the naso-pharynx.) The tube being open, the loop can becompletely withdrawn into it, so that even polypi of greater consis-tence than usual are entirely cut through, while with Blakes instru-ment this is frequently not quite possible, and the remaining por-tion of the polypus requires to be torn or twisted off. The very thinnest flexible iron wire is used, such as gardenersemploy for binding up flowers, or thin silver wire. The loop ismade corresponding to the size of the polypus. It is most con-venient to give the loop a roundish shape over a speculum, and 193 Fig. 40. 194 TREA TMENT OF POL YPI. then to bend it somewhat on the flat. When the place of attach-ment of the polypus is ascertained, we place the tube of the snaretowards the corresponding side of the meatus. The loop is nowpassed over the polypus, pressed downwards as much as possible,and then withdrawn. As a rule, we do not succeed in removingthe whole mass at the first attempt. After stopping the slighthaemorrhage by means of a cotton plug, the loop of the snare isreintroduced several times if necessary in order to remove whatremains. Easy as this operation is in the case of polypi situatedat the outer part of a wide meatus, it is very difficult when themeatus is narrow, and the polypi are seated very deeply in it or inthe tympanic cavity. But even in such cases these growths canbe reached by means of a snare with a thin tube, and under goodillumination. If this fail, caustics must be employed. Thehaemorrhage after using the snare
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