A manual of otology for students and practitioners . ortened by chiseling off a fewfine shavings. The remainder can be safely removedwith the small curette, which is inserted internal to itwith one cutting edge pressed against it (Fig. 91). Byusing the upper border of the bone wound as a fulcrum,the spoon of the curette is moved directly outward inthe line of the external auditory canal. Only a littleshould be taken at a time and the probe should be usedeach time to determine the amount of overhang stillremaining before an additional piece is taken. In remov-ing the last piece, the side of the
A manual of otology for students and practitioners . ortened by chiseling off a fewfine shavings. The remainder can be safely removedwith the small curette, which is inserted internal to itwith one cutting edge pressed against it (Fig. 91). Byusing the upper border of the bone wound as a fulcrum,the spoon of the curette is moved directly outward inthe line of the external auditory canal. Only a littleshould be taken at a time and the probe should be usedeach time to determine the amount of overhang stillremaining before an additional piece is taken. In remov-ing the last piece, the side of the curette is in contactwith the bend in the Fallopian canal, and great painsshould be taken not to allow the curette to rotate andthus produce pressure with the back or side of the bowl THE RADICAL MASTOID OPERATIOX 283 against this canal, as a depressed fracture of the Fallopiancanal wall would be produced and facial paralysis this work so close to the nerve, the anesthetist watchesthe face carefullv and should anv twitches be seen, imme-. FiG. 91.—Method of using the curette in taking down the posterior overhang. diately reports the fact to the surgeon, so that havingwarning of the maneuver which disturbed the facialnerve and thus produced the twitches, he may not repeatit. The object in taking down the posterior overhangflush with the posterior tympanic wall is that if it is not 284 OTITIS MEDIA PURULENTA CHRONICA done a cavity will be left which interferes with subse-quent healing or the taking of grafts if they are removing the posterior overhang a dry field isnecessary; therefore, as soon as there is sufficient exposureof the tympanum, the ossicles are taken out and granula-tions removed with a sharp ring curette, with flexibleshaft, as from the latter troublesome bleeding often takesplace. The wound should be packed with gauze saturatedwith adrenalin solution to arrest the hemorrhage andobtain a dry field. Lowering the Facial Ridge.—The ridge of b
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Keywords: ., boo, bookcentury1900, bookdecade1910, booksubjectear, bookyear1916
