. A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . osterior portion of the mastoid processuntil this process has been fully excavated. Such thor-ough excavation is as necessary in these cases of sclerosisas it is in those first described, for in this tyiie of mastoida large cell is often found remotely situated from the an-trum, and yet filled with pus. In fact, I have operatedupon cases in which, while the antrum and ailjacent cellswere apparently free from p-ulent matter, a cell locatedposteriorly and near the t
. A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . osterior portion of the mastoid processuntil this process has been fully excavated. Such thor-ough excavation is as necessary in these cases of sclerosisas it is in those first described, for in this tyiie of mastoida large cell is often found remotely situated from the an-trum, and yet filled with pus. In fact, I have operatedupon cases in which, while the antrum and ailjacent cellswere apparently free from p-ulent matter, a cell locatedposteriorly and near the tip lias been found to be full ofpus. In cases in which a perforation has already taken placespontaneously iu the cortex of the mastoid, the use of thechisel is unnecessary; the surgeon may begin at once with i05 MaBloid Oi>cr;:ti! OperatioU!^. REFERE^^CE HANDBOOK OF THE JIEDICAL SCIENCES. tlie curette and follow the fistulous tract which existsand which alwajS leads into the antrum. After he hasreached this cavity he may proceed with curettes andforceps as iu the first typeof cases. In following such. d> ,.^ ?-J- Fig. 333S.—The Completett Operation for Simple Mastoirtitls. The digastric muscle is shown, atthe inferior portion of tlie field of operation, occupying the place previously occupied bythe removed mastoid tip. The upper portion of the operative field shows the ablation ofthe cells at the root of the zygomatic process. These cells at times extend farther fmwardthan is shown in the illustration. The illustration is also utilized to show the placiuir ofthe bent silver iir)be in jtosition, wiiich acts as a jruide in the removal of the posterior wallas is d(-in in the rarhcal operiitlon iscehelow). The probe is inlroflured lu-twcen the bonyand iiiciiiliranous walls of the external auditon canal into the miildle ear tluousrli the aditusand antrum aud its hulhous-lipped end shows in the e-xcavated antrum, (if course this probeis not used in cases of simpl
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