. Annals of surgery . ucti: axillary gland, and thes of the neck. use of mild alkaline and styptic mouth washes. With the patient in a semiu])right position, ether is administered by the ;haryngeal method. Thffield of operation is prepared with iodine, half strength solution being useein the mouth. The neck dissection is done first. A transverse incision, slighthcurved downward, is made from a point about 2 cm. below the lobe of the lef:ear to a corresponding point below the right ear. The knife is used in makingthe incision through the skin and dissecting back the flap. Then with th
. Annals of surgery . ucti: axillary gland, and thes of the neck. use of mild alkaline and styptic mouth washes. With the patient in a semiu])right position, ether is administered by the ;haryngeal method. Thffield of operation is prepared with iodine, half strength solution being useein the mouth. The neck dissection is done first. A transverse incision, slighthcurved downward, is made from a point about 2 cm. below the lobe of the lef:ear to a corresponding point below the right ear. The knife is used in makingthe incision through the skin and dissecting back the flap. Then with th( 466 CANCER OF THE TONGUE ; cautery knife, the lymphatic gland-bearing area is dissected oi masse from1 the entire cervical region thus exposed. In removing the submaxillary glandI on the healthy side care must be taken to preserve the hypoglossal ner\-e andI the lingual nerve (Fig. i), between which passes the duct of the gland. Asmall branch of the facial nerve supplying the ansjiilip oris, which depresses —y f 7. Fig. 2.— IV. Extent of cancerous growth invading the margin of the tongue. the angle of the mouth, is frequently injured in dissection close to the ramusof the jaw. This nerve is superficial and very small, but important because,if severed, it causes drooping at the angle of the lower lip. Perforation of thefloor of the mouth is occasionally unavoidable when the operation is done inone stage. This invariably complicates recovery by a disagreeable infection. On completing the dissection the skin margins are brought together and arubber tissue drainage is placed in either side of the neck. The second part of the operation follow^s and consists in removing a part467 IHILEMON E. TRUESUALE or whole of the tongue. In the three cases herewith reported this step wascarried out in the following manner ; The tongue was drawn forward on a retention suture passed through thetip. The mucous membrane on the floor of the mouth was then incised anddissected free, the line
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
