Transactions . muchtissue be removed and the gratitude of the patient terminatewith his hay fever. .\ f(.irm of lower tiu-binal hypertrophy cpiite frccpientlvoverlooked or disregarded by the surgeon is that in\ol\ingchiefly the posterior end. These may be either the usualsmooth siu^faced enlargements, or those described as the mul-berry or cauliflower hypertrophy. (See Fig. These con-ditions are so frequently associated with chronic nonsuppiua-tive middle ear catarrh that their removal appears to be indi-cated where this disease is present. In fact, it does not seema too radical ]iroeedure
Transactions . muchtissue be removed and the gratitude of the patient terminatewith his hay fever. .\ f(.irm of lower tiu-binal hypertrophy cpiite frccpientlvoverlooked or disregarded by the surgeon is that in\ol\ingchiefly the posterior end. These may be either the usualsmooth siu^faced enlargements, or those described as the mul-berry or cauliflower hypertrophy. (See Fig. These con-ditions are so frequently associated with chronic nonsuppiua-tive middle ear catarrh that their removal appears to be indi-cated where this disease is present. In fact, it does not seema too radical ]iroeedure to ])ractice their removal i)rior to ni the onset of the middle ear syinptoins. done simply as aprophylactic measure. Having tried and condemned the subject of this paper onthese several different counts, it now remains for us to passsentence best befitting the crime, and to determine the pro-cedure most suitable for its execution. It is an unfortunatefact that those operations on the lower turbinal bndv which. Fig. turbinates with polypoi3 hypertrophy of the posterior ends. are the most conservative are the most difficult to is very seldom indeed that one finds any occasion for a com-plete inferior turbinectomy, yet such an operation is infinitelyeasier to do than is the careful, well executed reason for this is purely anatomic. (See Fig. 1.) Thenarrow, bony attachment to the nasal wall is so easily severedeither by the scissors or by the spoke shave or the saw thatthe temptation has in the past been too strong for some opera- 273 tors to resist. Even at the present time we occasionally findsurgeons holding over from the century preceding who con-tinue to practice as a routine this simple operation, so un-complicated in its execution, yet so certain to be followed bycomplications most unpleasant for the patient. Where the bone lies in firm contact with the lateral nasalwall (see Fig. 3) it may be dealt with tither by removingthe oiifendin
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