Diagnosis and treatment of ear diseases . -tion are so slight, that he may withperfect propriety advise against far as the operation itself isconcerned, it may be described asfollows: A free vertical incision shouldbe first made through the skin andperiosteum covering the mastoidbone. The condition of the lattershould then be noted. If it be softor roughened, an attempt shouldbe made to break through the outerlamella by firmly pressing upon itwith the end of a steel director. Ifpus be found between the perioste-um and the bone, search should bemade with a bent probe for a sinusthrough wh
Diagnosis and treatment of ear diseases . -tion are so slight, that he may withperfect propriety advise against far as the operation itself isconcerned, it may be described asfollows: A free vertical incision shouldbe first made through the skin andperiosteum covering the mastoidbone. The condition of the lattershould then be noted. If it be softor roughened, an attempt shouldbe made to break through the outerlamella by firmly pressing upon itwith the end of a steel director. Ifpus be found between the perioste-um and the bone, search should bemade with a bent probe for a sinusthrough which the pus may have found an escape from the mastoid cells. Ifsuch an one can be found, the drill should be applied at this point, and theexisting channel or fistulous opening should simply be enlarged. If no open-ing be found, the periosteum should be dissected from that portion of themastoid process which is situated immediately behind the external auditorycanal, and the drill1 should be applied at a point a quarter of an inch distant. Fig. 27.—Bone drills. (Natural size.) 1 Of the two drills represented in the cut, I almost always employ the larger gives the preference to small bone gouges and chisels, which he uses inconnection with a mallet. I fail to appreciate, however, in what respect these instru-ments are superior to the drills represented above. DISEASES OF THE EAK. 369 from the canal and a little below the level of its upper wall. The instrumentshould then be rotated in a direction inward, forward, and a little upward—that is, nearly parallel with the canal. The depth to which it should be car-ried will vary in different cases. In the acute cases the aim should be to reachthe peculiar cell-structure of the mastoid process. Ordinarily, it will bereached at a slight depth. The drill should then be withdrawn and thesteel director may be used to break down the bony septa. In infants theantrum is situated so near the outer surface of the bone that very
Size: 1278px × 1954px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthorbuckalberthalberthenr, bookcentury1800, bookdecade1880
