Operative surgery . ingly as the operator the growth be a small one,but one side of the hard pal-ate need be attacked. Chalofs Method.—jyiviciethe gingivo-labial fold and separate the upper lip from the bone at a pointcorresponding to the anterior nasal spine, thus opening into the nasalfossae in front. Draw the canine teeth, open the mouth widely, and makean incision down upon the under surface of the hard palate at either sideclose to the alveolus, beginning at the empty socket of the canine tooth,and terminating at the posterior border of the bone (Fig. 757, b, b); dividethe alve
Operative surgery . ingly as the operator the growth be a small one,but one side of the hard pal-ate need be attacked. Chalofs Method.—jyiviciethe gingivo-labial fold and separate the upper lip from the bone at a pointcorresponding to the anterior nasal spine, thus opening into the nasalfossae in front. Draw the canine teeth, open the mouth widely, and makean incision down upon the under surface of the hard palate at either sideclose to the alveolus, beginning at the empty socket of the canine tooth,and terminating at the posterior border of the bone (Fig. 757, b, b); dividethe alveolus and hard palate at either side in the line of incision withchisel and mallet; separate the bony flap thus formed from its connec-tions with the vomer and nasal mucous membrane; displace it downwardand backward into the mouth, the velum acting as a hinge; remove thegrowth; restore and fasten the bone flap in place with wire sutures. Thisprocedure is ingenious and effective except when the growths are large and. Pifi. 75^ iSeialoiis method, b. C/halots method. OPKRATIONS ON 11 IK NOSK. 5^5 locutid at till vault of tin- jiliaiviix. The cle^ntH! of liaiiiorrlia^o iti thisoi)eratii>ii is an important item, and sugfjosts the advisability of tracheotomyand a ))haryng(al tam[)()n as wise preliminary measunjs, especially as thepresence of the l)one llap will impede the manipulations of the surgeon. A)iii(tii(lah\< McUkiiI.—Expose the anteiior nares as advised by Rouge(page AS!)); divide tlui bony septum at its connections with the maxilhe;open the mouth widely and make an incision in the median line of the hardpalate down to tlu hone; remove a middle incisor if need be, and divide thealveolus and hard i)alate in the median line with a small saw introdiu-edthrougli the nose. The soft palate is not disturbed unless the size or positionof the morbid growth calls for it. The maxilhi; are pried aj)art or drawnasunder with hooks, if required, carefully avoiding displacement of
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