A manual of otology for students and practitioners . rformedunder brilliant illumination. The tympanic membraneis completely separated from the tympanic ring by asmall scalpel. It is well to start this with a knife havinga very sharp point, then to substitute one with a probepoint in order not to wound the mucous membrane, andthus increase the hemorrhage. The next step is dividing the incudostapedial articula-tion. This will not be necessary if there has been necrosisand sloughing of the long process of the incus. This isaccomplished with a small knife, the blade of which is OSSICULECTOMY 271
A manual of otology for students and practitioners . rformedunder brilliant illumination. The tympanic membraneis completely separated from the tympanic ring by asmall scalpel. It is well to start this with a knife havinga very sharp point, then to substitute one with a probepoint in order not to wound the mucous membrane, andthus increase the hemorrhage. The next step is dividing the incudostapedial articula-tion. This will not be necessary if there has been necrosisand sloughing of the long process of the incus. This isaccomplished with a small knife, the blade of which is OSSICULECTOMY 271 at a right angle with the shaft. This is inserted from infront between the long process of the incus and theinternal tympanic wall with which the flat of the bladeis in contact. Upon rotation of the instrument, the blademoves downward and severs the connection betweenthe incus and stapes. If there is an adhesion betweenthe manubrium and the internal tympanic wall, it may bedivided in the same manner; or a ring knife, resembling f) rO €>i ^ ^^^. Fig. 85.—The Politzer set of instruments for performing ossiculectomy. the sharp ring curette, may be slipped over the end of themanubrium with the cutting edge upward, and graduallyforced tln^ough the adhesion, or if there is no adhesion,this instrument gradually worked upward will sever thetendon of the tensor tympani and the ligaments hold-ing the malleus in position. This loosens the ossicleand it may be delivered with a small angular incus is now removed with a hook designed for 272 OTITIS MEDIA PURULENTA CHRONICA that purpose. These hooks are made right and the appropriate one, it is worked up posteriorto the ossicle, then by rotating the instrument, the hookwith the incus engaged is brought down into the atriumand removed with the forceps. Considerable skill is at
Size: 3334px × 750px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., boo, bookcentury1900, bookdecade1910, booksubjectear, bookyear1916
