The practice of surgery . scle,aponeurosis, and skin, thus delimit-ing and controlling an excessivehernia. Suboccipital explorations arewell made through an approach by Cushings cross-bow incision. In this fashion, as the drawing illustrates,one maj^ lay bare comfortably the lower portion of the occiput and mayremove bone, covering in the gap subsequently by heavy layers of muscleand aponeurosis. Surgeons approach the base of the skull by other routes and in otherquarters—the anterior fossa through the temporal bone or even throughthe frontal bone; and operators have sought the pituitary fossa
The practice of surgery . scle,aponeurosis, and skin, thus delimit-ing and controlling an excessivehernia. Suboccipital explorations arewell made through an approach by Cushings cross-bow incision. In this fashion, as the drawing illustrates,one maj^ lay bare comfortably the lower portion of the occiput and mayremove bone, covering in the gap subsequently by heavy layers of muscleand aponeurosis. Surgeons approach the base of the skull by other routes and in otherquarters—the anterior fossa through the temporal bone or even throughthe frontal bone; and operators have sought the pituitary fossa by goingdirectly under the front allobes after turning down a large frontal bone-flap, or by working through the nasal passages and accessory operations about the base are almost always associated with ob-stinate, and sometimes with serious, hemorrhage from large veins,so that the operations must be undertaken with caution, pains, anddiscretion. It is not probable that such difficult and delicate explora-. Fig. 430.—Cushings method of clos-ing scalp before removal of ridge of tissue made by sutureswhen tied (.Gushing in Keens Surgery). 668 THE HEAD AND SlINE tions will find favor with <iviieial surgeons in the near future. Theseare matters more partic-ulari}- for the carefully trained neurologicsurgeon. At the beginning of this chapter I made some mention of the diflicul ?ties and of the promise of intracranial surgeiy. In its modern aspects L
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
