A manual of otology for students and practitioners . triangular process of bone which Hesbetween the vestibule and the internal auditory meatus ends at the vestibule, as the vestibularnerves occupy its posterior part and some of them passdirectly into the vestibule, which thus becomes theguide to the internal end of the meatus. With the curette,small gouges and chisels the triangular piece of bone isremoved, taking care that the diu*a is separated from thebone. Neumann advises that the dura in the middle NEUMANNS OPERATION 341 fossa be exposed but the author prefers to leave the mn
A manual of otology for students and practitioners . triangular process of bone which Hesbetween the vestibule and the internal auditory meatus ends at the vestibule, as the vestibularnerves occupy its posterior part and some of them passdirectly into the vestibule, which thus becomes theguide to the internal end of the meatus. With the curette,small gouges and chisels the triangular piece of bone isremoved, taking care that the diu*a is separated from thebone. Neumann advises that the dura in the middle NEUMANNS OPERATION 341 fossa be exposed but the author prefers to leave the mnertable in this location until the end of the operation fortwo reasons: (1) There is more danger of wounding thesuperior petrosal sinus if the angle of bone between theposterior and middle fossae is taken out. This has occiu-redand the bleeding is a serious matter, as the field becomescompletely obscured; (2) this process supports the boneupon which one is working and prevents fracture in someuntoward locality. That this danger is real is shown by. Fig. 114.—Neumanns labyrinth operation. The internal auditorymeatus opened but not incised. the sensation of instability communicated to ones handat each stroke of the mallet. iVs removal of this triangularpiece proceeds a bent probe passed between the dura andposterior surface of the petrous pyramid will soon slightlyenter the internal auditory meatus. Thus both endsof the meatus being established, it only remains to removethe bone between them, when the dura lining the internalauditory canal is exposed (Fig. 114). This is opened bya longitudinal incision. If an abscess is found, no furtherdural incision is to be made unless meningitis is known to 342 SUPPURATIVE DISEASES OF LABYRINTH be present. If an abscess is not discovered, the incisionshould be continued into the cerebellar dura. The durain the middle fossa may now be incised, the inner tablebeing removed if it has not already been done. Cochlear Drainage.—Before these dur
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Keywords: ., boo, bookcentury1900, bookdecade1910, booksubjectear, bookyear1916
