. Manual of operative surgery. Fig. 141.—Grant. {Bryants Op. Surg.) Fig. 142.—Grant. (Bryants Op Surg.) Method B.—For very extensive lesions. Step I.—Excise the tumor, preferably by incisions which form a trianglewith its apex below, so that a cut may run down from the apex to expose thelymphatics beneath the jaw. Step 2.—On each side proceed as follows: From the angle of the mouth makean incision (A, B, Fig. 146) directed towards the inferior border of the tragus. s?^> y_ ^ ^(^Sife^. Fig. 143.—{Nilalon and Ombridanne.) Divide the skin only. Open the mouth. Mucous membrane exists under thea
. Manual of operative surgery. Fig. 141.—Grant. {Bryants Op. Surg.) Fig. 142.—Grant. (Bryants Op Surg.) Method B.—For very extensive lesions. Step I.—Excise the tumor, preferably by incisions which form a trianglewith its apex below, so that a cut may run down from the apex to expose thelymphatics beneath the jaw. Step 2.—On each side proceed as follows: From the angle of the mouth makean incision (A, B, Fig. 146) directed towards the inferior border of the tragus. s?^> y_ ^ ^(^Sife^. Fig. 143.—{Nilalon and Ombridanne.) Divide the skin only. Open the mouth. Mucous membrane exists under theanterior portion of the cut A, B. Divide the mucous membrane parallel to butabout }/s inch above the skin incision. (By suturing the mucosa to the skin ared border is provided for the new lower lip.) Make the skin incision B, Cparallel to the wound made in the excision of the disease. The lower end of thecut B, C, is about a fingers breadth below the lower border of the lower jaw. Inmaking the cuts A, B and B, C do not injure the parotid. Reflect the flap out- NELATON-OMBREDANNE OPERATION 121 lined by the cuts AB, BC; to do this it is necessary to divide the mucosa verti-cally along the the anterior edge of the masseter. Be careful not to divide thefacial artery where it crosses the border of the lower jaw, but separate it, with theflap, from the jaw. Step 3.—Clear away the lymphatics and the submaxillary glands but care-fully preserve the facial artery; if necessary, the faci
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