Diseases of the nose and throat; a text-book for students and practitioners . reaten life, thepatient should be intubated at once, or the air-passages openedbelow the point of obstruction, when, if the respiratory difficultyis not very severe, it is often possible to dilate the stricture suffi- 446 DISEASES OF THE NOSE AND THROAT. ciently to relieve the symptoms, thus saving the sufferer thefrequent annoyance of wearing a tracheotomy cannula the re-mainder of his life. Dilatation of-^the larynx, without preliminary tracheotomy,may be accomplished either by Schrotters hard-rubber bougiesor ODwy
Diseases of the nose and throat; a text-book for students and practitioners . reaten life, thepatient should be intubated at once, or the air-passages openedbelow the point of obstruction, when, if the respiratory difficultyis not very severe, it is often possible to dilate the stricture suffi- 446 DISEASES OF THE NOSE AND THROAT. ciently to relieve the symptoms, thus saving the sufferer thefrequent annoyance of wearing a tracheotomy cannula the re-mainder of his life. Dilatation of-^the larynx, without preliminary tracheotomy,may be accomplished either by Schrotters hard-rubber bougiesor ODwyers intubation tubes. The former have long beentested and sometimes proved highly useful, but will, doubtless,disappear in favor of the intubation apparatus. When prepar-ing to use bougies it is usually necessary to begin with anEnglish catheter; when this can be tolerated, a very smallbougie may be carefully introduced and left in position for afew seconds; if not too irritating it may be re-inserted after afew minutes rest, and then can be left a longer time, the instru-. FiG. 116.—Schrotters Hard-Rubber Bougie. d, beak to fit into glottis ; c, portion which r«sts upon the tongue ; h, guides ; a, curved tip for directingdischarges from operators face. ment projecting from the mouth. As soon as the larynx becomestolerant of the bougies, the largest size that can be borne maybe inserted and, perhaps, left in position ten or fifteen minutes,during which time the patient is obliged to keep his mouth openand hold a towel below his chin to catch the saliva, whichusually flows freely. In the use of the ODwyer tube, thepatient is enabled to close the mouth after the tube is well inposition ; so that it can be left in situ several days if necessary,not only rendering the procedure less disagreeable, but greatlyhastening dilatation, owing to continued pressure. It is notprudent to use the bougies where there is grave stenosis, butthe intubation apparatus can be advantageously employ
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