War surgery of the faceA treatise on plastic restoration after facial injury by John BRoberts ..Prepared at the suggestion of the subsection on plastic and oral surgery connected with the office of the surgeon generalIllustrated with 256 figures . cing the eyeball, preventing properclosure of the lids, and by causing bulging of the bones, whichconstitute the walls of the orbit. Tumors or large pus collections or pieces of shell or shrapnelmay cause exophthalmos, or protrusion of the entire ball, or devia-tions, usually to the side away from the object causing often cause double v
War surgery of the faceA treatise on plastic restoration after facial injury by John BRoberts ..Prepared at the suggestion of the subsection on plastic and oral surgery connected with the office of the surgeon generalIllustrated with 256 figures . cing the eyeball, preventing properclosure of the lids, and by causing bulging of the bones, whichconstitute the walls of the orbit. Tumors or large pus collections or pieces of shell or shrapnelmay cause exophthalmos, or protrusion of the entire ball, or devia-tions, usually to the side away from the object causing often cause double vision by displacement of one globe. Mucous retention and abscesses associated with disease of the 426 WAR SURGERY OF THE FACE. frontal or ethmoid sinuses also encroach upon the orbit and mustbe remembered. Fractures and gunshot wounds of the intra-cranial blood vessels may cause a pulsating exophthalmos withpulsation and aneurismal thrill in the protrusion. Such casesmust be studied with care and treated by an endeavor to shutoff the blood current in the wounded artery or vein. Some orbital foreign bodies are removable without sacrificingthe eye itself, while others are reached only after a temporaryresection of a part of the orbital s— Fig. 254.— Kroenleins operation of temporary resection of outer wall oforbit to remove orbital growths. (Knapp.) If access to the seat of the bullet or other missile is desired forextraction without damaging the eyeball, a cut is made at thebony margin of the orbit and the orbital fat and the eyeball withits attached muscles are displaced so that the imbedded projec-tile may be enucleated. The object is then removed with forceps,the wound disinfected, and the globe of the eye permitted to fallinto its place. Drainage may or may not be necessary. The REPAIR OF TRAUMATIC DEFORMITIES OF EYELIDS AND GLOBE. 427 external side of the orbit perhaps gives better access to theorbital cavity than other regions, but the site of the bullet mustbe
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
