The Journal of laryngology and otology . recurrent papillomata have to be removed enco-laryngeally(Bornemann). The results as to phonation are certainly less favourable withlaryngo-fissure than by the endo-laryngeal method. Thyrotomy is practised forpapilloma in the child, only in default of a better method. In a little girl with laryngeal papillomata, the author endeavoured to removethe papillomata by the endo-laryngeal method, but his efforts remained fruitlessuntil the idea occurred to him of employing a modified intubation uilh a fenes-trated tube. With this method, he further believes, th
The Journal of laryngology and otology . recurrent papillomata have to be removed enco-laryngeally(Bornemann). The results as to phonation are certainly less favourable withlaryngo-fissure than by the endo-laryngeal method. Thyrotomy is practised forpapilloma in the child, only in default of a better method. In a little girl with laryngeal papillomata, the author endeavoured to removethe papillomata by the endo-laryngeal method, but his efforts remained fruitlessuntil the idea occurred to him of employing a modified intubation uilh a fenes-trated tube. With this method, he further believes, that many cises of benigngrowths in the larynx may, in the child, be operated on «ndo-laryngeally, wheiethyrotomy would be employed. The exact situation of the growth must bedetermined laryngoscopically. An intubation tube, pierced 7iith a fenestium,situated exactly over the tumour, so that the latter dillproject into the tube, is thenemployed. (See figures: the applicator one-third natural size, the tube three-quarters natural size.) I. Having inserted a tube, of dimensions corresponding to the age of the child,examination with the laryngoscope is made to determine if the neoplasm appearsin the fenestrum of the tube. A suitable forceps, curette, snare, porte-caustique,or other instrument is then introduced into the tube, under guidance of the finger,and the growth is removed. In children of tender age it is important to use tubescylindrical and with thin walls, and not flattened and thick-walled tubes, theformer having a greater lumen, and more easily permitting the introduction oflaryngeal instruments. Experiments on the cadaver show that the upper projectingedge of the tube rests on the ventricular bands, which prevent its falling into thetrachea, the neck of the tube corresponding to the level of the vocal cords. Forgrowths of the vocal cords, the fenestrum ought to be cut with its centreimmediately above the thick border of the tube, and lower down for sub-glottictumours. F
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Keywords: ., bo, bookcentury1800, booksubjectear, booksubjectnose, bookyear1887
