. Manual of operative surgery. Fig. 255.—Second stage. (By permission from the British Journal of Surgery.) Step 3.—PulHng the mobilized segment away from the tongue, close thewedge-shaped wound with sutures. This stops bleeding. Step 4 —Step by step continue the wedge-shaped excision along the edgeof the tongue and apply sutures to stop bleeding. When the level of the lastmolar tooth is reached finish the dissection on that side (Fig. 255). In similarfashion resect the opposite side of the tongue. i6o TONGUE The lower incision should be at the junction of the smootli mucosa of theundersurface
. Manual of operative surgery. Fig. 255.—Second stage. (By permission from the British Journal of Surgery.) Step 3.—PulHng the mobilized segment away from the tongue, close thewedge-shaped wound with sutures. This stops bleeding. Step 4 —Step by step continue the wedge-shaped excision along the edgeof the tongue and apply sutures to stop bleeding. When the level of the lastmolar tooth is reached finish the dissection on that side (Fig. 255). In similarfashion resect the opposite side of the tongue. i6o TONGUE The lower incision should be at the junction of the smootli mucosa of theundersurface of the tongue with the papillary mucosa of the dorsum. Thedorsal incision must be made internal to the tissue it is desired to smooth infralingual mucosa being preserved makes an excellent flap forthe reconstruction of the margins of the tongue (Fig. 256). L^ J. Fig. 256.—The operation completed. (By permission from the British Journal of Surgery.) When a small tumor exists near the tip of the tongue, it may be removedby means of a V-shaped incision. Dieffenbachs Operation.—^Local anesthesia usually sufi&ces. If a generalanesthetic is used, the mouth must be kept open during the operation by amouth-gag. Pull the tongue forwards by means of a volsellum or a stout
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