A text-book of the diseases of the ear and adjacent organs . only fragments of it are removed. In the case of polypi soft throughout, extraction with the snare is seldom complete, as the soft tissue is easily cut through. b. Ligature.—When a fibrous polypus is so closely connected with the osseous wall that considerable resistance is shown on strong traction, it is proper to use Wildes snare to constrict the polypus, the instrument after its loop is tightened being turned on its long axis till a greater resistance is felt. Then the wire fastened to the cross-bar is cut through with scissors, a
A text-book of the diseases of the ear and adjacent organs . only fragments of it are removed. In the case of polypi soft throughout, extraction with the snare is seldom complete, as the soft tissue is easily cut through. b. Ligature.—When a fibrous polypus is so closely connected with the osseous wall that considerable resistance is shown on strong traction, it is proper to use Wildes snare to constrict the polypus, the instrument after its loop is tightened being turned on its long axis till a greater resistance is felt. Then the wire fastened to the cross-bar is cut through with scissors, and the instrument removed from the ear. By the twisted wire loop left in the ear the passage of blood to the polypus is stopped, a, Root; b, Place of thereby causing its rapid mortification and dis-constriction; c, Wire , « ligature. charge. This sometimes follows in the nrst twenty-four hours, and sometimes not for several days, while it is frequently only the peripheral, constricted part of the polypus that is discharged. Only in some few cases have I. Fig. 281. excision. 537 observed the simultaneous discharge of the root from the under-lying tissues (Fig. 281). If the polypus be not removed at the endof a few days by the use of this wire ligature, by catching the endsof the ligature with the dressing-forceps we may now try to extractthe polypus; or in case the obstacle still proves too great, we mayincrease the twisting of the snare. c. Excision.—In the case of large polypi, with roots so deep thatwe cannot with certainty ascertain whether the growth proceedsfrom the external meatus, the membrana tympani, or the tympaniccavity, extraction, owing to the danger of tearing out one of theossicles or the cochlea (Toynbee, Boke), is to be avoided, and excisionof the polypus should be undertaken. For this purpose Blakes polypus snare is the best (Fig. 282). It is a mov-able metal cannula into which the wire loop can be completely withdrawn.(jreat importance must be placed upo
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Keywords: ., bookcentury1800, bookdecade1890, booksubjecteardiseases, bookyear
