The diseases of the ear and their treatment . e place of constriction in this manner, its point, instead of beingbrought again toward the perpendicular, should be turned stillmore outward. If the beak be short and the lower nasal meatuswide, its convex surface will then slide across the convexity of theseptum down into the lower meatus, where it will now lie. It canthen be pushed forward, the beak again being raised perpendicularlyby lowering the outer end of the catheter, or it is even better topush the beak forward in a horizontal direction into the posteriorportion of the nasal cavity, and
The diseases of the ear and their treatment . e place of constriction in this manner, its point, instead of beingbrought again toward the perpendicular, should be turned stillmore outward. If the beak be short and the lower nasal meatuswide, its convex surface will then slide across the convexity of theseptum down into the lower meatus, where it will now lie. It canthen be pushed forward, the beak again being raised perpendicularlyby lowering the outer end of the catheter, or it is even better topush the beak forward in a horizontal direction into the posteriorportion of the nasal cavity, and then to turn it upward behind theposterior border of the lower turbinated bone. After the beak withits point directed upward has been introduced into the naso- THE AIR-DOUCHE. 43 pharynx, it receives another turn through an angle of i8o°, whichwill again give it a downward direction. It is advisable to employin such cases thin catheters with a short beak. In cases of obstruc-tion the introduction of the catheter may be much facilitated by a. Fig. 22. 6. Septum. Vk. Convexity. /. Inferior meatus. //. Middle meatus. B. Floor of nasal cavity. Af. Alveolar process. Hh. Anterior extremity of Antrum of Highmore. Sh. Frontal air-sinus. Sz. Ethmoid cells. Ah. Orbit. careful preliminary inspection of the nasal cavity, and by ascertainingthe nature of the obstruction. If the catheter lie in the middlemeatus, the second act of catheterism, namely, turning the beak inthe naso-pharynx, and inserting its point into the orifice of theEustachian tube, will be very difficult, or impossible. If the one 44 THE AIR-DOUCHE. nostril will not admit of the passage of the catheter, an attemptshould be made to introduce one with a long beak through theother nostril, and thence to insert it into the opposite Eustachiantube. Act II. After the point of the beak has reached the posteriorpharyngeal wall, the catheter is held between the thumb and fore-finger of the left hand in order to support it easily; i
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