Surgical therapeutics and operative technique . tions with theshears. The first divides the ascending process of the maxilla; the second,after division of the velum palati \vith a bistoury, divides the whole lengthof the palatine arch; the third, the zygomatic arch; finally, the fourth,penetrating behind the tuberosity of the maxilla, effects the disjunctionof the spheno-maxillary suture. Fourth Stage: Extirpation of the Bone.—The bone is seized A\iththe jaws of a suitable forceps, and removed like an ordinary molar, takingcare to divide the last remaining fibro-muscular attachments with sciss


Surgical therapeutics and operative technique . tions with theshears. The first divides the ascending process of the maxilla; the second,after division of the velum palati \vith a bistoury, divides the whole lengthof the palatine arch; the third, the zygomatic arch; finally, the fourth,penetrating behind the tuberosity of the maxilla, effects the disjunctionof the spheno-maxillary suture. Fourth Stage: Extirpation of the Bone.—The bone is seized A\iththe jaws of a suitable forceps, and removed like an ordinary molar, takingcare to divide the last remaining fibro-muscular attachments with scissors,and also the infraorbital nerve, if not previously divided. The internalmaxillary artery is usuallj^ the only one which is met with in the depth ofthe wound. It is seized with a forceps with short jaws and claws, and tiedwith silk. FiPTH Stage: Reunion op the Wound.—After tamponing the wound,the skin is sutured with silk or Florentine hair. The tampon is removedafter three or four days. A prothetic piece of covering is finally


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