Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . finger to render it pliable. The nose is held openwith retractors. A vertical incision is made along in front of the deflection,if possible posterior to the free anterior border of the septal should pass down to the floor of the nose. It should curve backward atits lower end, and proceed back below the deflection. The incision shouldpass through the mucous membrane and slightly into the cartilage. A Fig. 856.—Angular Knives Used for Operations on the
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . finger to render it pliable. The nose is held openwith retractors. A vertical incision is made along in front of the deflection,if possible posterior to the free anterior border of the septal should pass down to the floor of the nose. It should curve backward atits lower end, and proceed back below the deflection. The incision shouldpass through the mucous membrane and slightly into the cartilage. A Fig. 856.—Angular Knives Used for Operations on the Septum. sharp and narrow elevator should be inserted and the mucous membraneand perichondrium covering the deformity lifted away from the cartilage asfar back as possible. With a sharp curet or swivel knife an opening isscraped through the exposed cartilage. Through this opening the elevatoris passed and the mucous membrane and perichondrium lifted away fromthe septum on the other side. Care should be taken not to penetrate the mucosa. The bulging partof the septum is now cut away by pieces with the fine rongeur forceps. As. Fig. 857.—Septum holding, bending and shaping septum. the morcellement progresses the elevation of the uncut mucosa proceeds, afinger in the nostril protecting it from penetration. The operation may becontinued until all of the bulging cartilage has been removed. It is necessaryto leave a bridge of cartilage at the anterior border to prevent falling of thetip of the nose. The flap of mucous membrane is put back in place and fixedby one or two sutures or it may be held by a carefully applied tampon. Thetampon should be saturated with petrolatum. The dressing may be removedin twelve hours. Some surgeons obviate the need of dressing by passing afew quilting sutures through and through. Fine catgut is used. No nasal 192 SURGICAL TREATMENT tube is required. The lines of incision through the mucous membrane mayvary to meet the conditions present.
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
