Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . elli, and in the region of the frontonasal angle, havingpassed through a defect in the ethmoid bone. Meningocele, hydrencephalocele, TREATMENT OF INJURIES AND DISEASES OF THE HEAD 93 encephalocystocele, and cenencephalocele are all variations of this form ofencephalomeningeal hernia. The important fact in the treatment is thatthey are congenital defects which are apt to be associated with other defectssuch as spina bifida, hydrocephalus, and other brain abnormalit
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . elli, and in the region of the frontonasal angle, havingpassed through a defect in the ethmoid bone. Meningocele, hydrencephalocele, TREATMENT OF INJURIES AND DISEASES OF THE HEAD 93 encephalocystocele, and cenencephalocele are all variations of this form ofencephalomeningeal hernia. The important fact in the treatment is thatthey are congenital defects which are apt to be associated with other defectssuch as spina bifida, hydrocephalus, and other brain abnormalities, whichoften render a complete cure difficult, if not impossible. The treatmentby compression, tapping, reduction and retention, or by the injection ofirritating substances has in rare cases been successful. It is not to berecommended. The skin over these tumors should be kept healthy and clean, lest ulcera-tion and sloughing lead to infection. The rational surgical treatment con-sists in exposure of the hernia, reduction or removal, and closure of theopening. As much of the scalp should be removed as is necessary^to avoid. Fig. 754.—Nasobuccal Approach to Hypophysis; Speculum in Place. Nasal cutting forceps are removing wall of sphenoidal sinus. The gauze sponge in the naso-pharynx is controlled by a thread passing forward through the nostril. redundancy. The incision should be carried down to the meninges. In acomparatively large tumor the meninges will be found much may be an absence of dura, and the pia-arachnoid will be foundlying against the connective tissue of the scalp. The treatment of the her-niated tissue must depend upon its structure. If the thinned-out meningesand nerve tissue enclose a chamber of cerebrospinal fluid which communi-cates with a ventricle, as is usually the case, the fluid may be drawn off andthe hernia reduced; or the herniated structures may require to be excised andthe meningeal wound sutured with fine catgut. If enough dura i
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
