. The Journal of laryngology and otology. t instrument to work with. Having located the mound ofthe agger nasi cells, or, if it is not present, having brought intoview the anterior end of the middle turbinate, the curette is pushedupward into the olfactory cleft with the cutting edge outward and 240 The Journal of Laryngology, [May, 1914. aimed and then pressed toward the lachrymal bone. If the curetteis in the right place it easily enters the ethmoidal labyrinth. Thecurette has an allowable excursion varying with the labyrinth of ahalf a centimetre to a centimetre and a half. If the curette i
. The Journal of laryngology and otology. t instrument to work with. Having located the mound ofthe agger nasi cells, or, if it is not present, having brought intoview the anterior end of the middle turbinate, the curette is pushedupward into the olfactory cleft with the cutting edge outward and 240 The Journal of Laryngology, [May, 1914. aimed and then pressed toward the lachrymal bone. If the curetteis in the right place it easily enters the ethmoidal labyrinth. Thecurette has an allowable excursion varying with the labyrinth of ahalf a centimetre to a centimetre and a half. If the curette iscarried too far it enters the orbit. . After the initialoutward plunge the handle of the curette is brought into the linewith the antero-posterior axis of the labyrinth. With the bowl upand the cutting edge downwards, the curette is carried backwardand downward until the bulla has been entered and means a backward excursion of half an inch. . Theloose part of the middle turbinates is now cut oif with a 1/ ~k/c:jo-^^\\ Fig. 11. -Traced from Moshers diagram to show X, the point at which thecurette is carried into the ethmoidal labyrinth. The cutting surface of the curette is now turned forwardsand a little outward and brought forward until the flint-like posterioredge of the superior maxilla is encountered. ^ Since writing my paper, by the courtesy of Max Halle I amenabled to place before you his recently modified operative method,hitherto unpublished, and the fact that he has felt it desirable toimprove on his published methods so as to render it moie freefrom danger shows that he realises the risks of his previous opera-tion. The following paragraphs are translations from Dr. Hallesletter to me. The method formerly proposed by me I still think good, butI have greatly imj)roved the procedure. It has, up to now, notbeen made public. ^ Laryngoscope, September, 1913, p. 13. May, 1914. Rhinology, and Otolo§fy. 241 An incision is made through the mucosa
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