. Manual of operative surgery. utlined by the cuts 8-7-1-2-3-4-5-6 includedthe entire left nostril, the w^hole thickness of the cheek and exposed both thenasal and oral cavities. An incision penetrating the skin alone was now made between the points6 and 8 and the cheek flap was removed with the lymphatics and glands enmasse. Those removed consisted of the left maxillary glands, just below theorbit, the lymphatic vessels (and ? glands) in the left buccinator region, bothsubmaxillary, salivary and lymphatic glands, both submental glands, and the 184 OPERATIONS UPON THE NOSE left superficial and
. Manual of operative surgery. utlined by the cuts 8-7-1-2-3-4-5-6 includedthe entire left nostril, the w^hole thickness of the cheek and exposed both thenasal and oral cavities. An incision penetrating the skin alone was now made between the points6 and 8 and the cheek flap was removed with the lymphatics and glands enmasse. Those removed consisted of the left maxillary glands, just below theorbit, the lymphatic vessels (and ? glands) in the left buccinator region, bothsubmaxillary, salivary and lymphatic glands, both submental glands, and the 184 OPERATIONS UPON THE NOSE left superficial and deep cervical glands. To expose the glands below the jawand to provide a flap to repair the defect in the nose and cheek the incisions8, 5, 4, 3, 2 were made and the outlined flap was fixed by sutures into itsnew bed. A split made in the flap (Fig. 283 insert 2-2-x) aided in fashion-ing the new nostril. The wound in the neck was easily closed. The resultwas satisfactory after some subsidiary patching operations had been •.# ...r Fig. 283.—Curtis operation. {After Curtis.) RHINOPLASTY Rhinoplasty, or the reconstruction of the nose, is called for in cases wherethe nose has been destroyed by disease or operation. The character of theoperative interference required varies with the location and extent of tissuedestruction. I. The destruction is confined to the soft structures of the nose but theosseous and a part of the soft structures of the nose remain. A. A relatively small portion of the soft parts has been destroyed. , 285, 286, 287 sufficiently the correction of this defect. 1. The defect is confined to one ala. Fritz Konig (Berlin, klin. Woch.,1902, No. 7), after thoroughly freshening the nasal defect, implanted into it aproperly shaped segment consisting of the whole thickness of the concha of theear. The result was excellent. 2. The defect extends beyond the ala but is still lateral. Langenbecks Operation.—From the sound side of the nose refle
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