Surgical therapeutics and operative technique . tial Resection of the Superior Maxilla. This operation is carried out, either for the treatment of an affectionof the bone itself, or of the maxillary sinus, or in order to reach the base ofthe skull by the transmaxillary route. 1. Removal of the Anterior Wall of the Maxillary Sinus.—This opera-tion is carried out with the same incision as that used in total extirpationof the bone, but taking care to preserve the lip, palatine vault, and dentalarcade. The object is to reach tumours situated on the outer wall of thenasal fossa on that side. Resect
Surgical therapeutics and operative technique . tial Resection of the Superior Maxilla. This operation is carried out, either for the treatment of an affectionof the bone itself, or of the maxillary sinus, or in order to reach the base ofthe skull by the transmaxillary route. 1. Removal of the Anterior Wall of the Maxillary Sinus.—This opera-tion is carried out with the same incision as that used in total extirpationof the bone, but taking care to preserve the lip, palatine vault, and dentalarcade. The object is to reach tumours situated on the outer wall of thenasal fossa on that side. Resection of the whole anterior wall of the sinus,then of its internal and posterior walls permits us to reach the base of theskull between the basilar apophysis and the foramen ovale. The trunkof the middle meningeal artery, when it bleeds repeatedly, should beobliterated in the foramen rotundum itself, either by folding back thevessel with the extremity of a forceps, or by introducing into the foramena splinter of bone removed from the Fig. -Nblatons Cutaneous Incision for Total Extirpation of theSuperior Maxilla. 2. Resection of the Alveolar Process.—This operation, which is necessi-tated by the presence of small tumours of the alveolar margin of the bone,differs from the operation on foci of caries and of necrosis, because the softparts, notably the gum, which is habitually invaded by the neoplasm,must be extensively extirpated with the latter. The operation shouldextend widely beyond the limits of the tumour. OPERATIONS ON THE HEAD 77
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