. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. position through such anincision ; necrosed cartilaginous fragments and impactedforeign bodies may likewise be removed thereby. Ifmore room is desired than the partial laryngotomy affords,the prolongation downward of the incision through asmany of the upper rings of the trachea as is necesssarymay suffice, and is to be preferred to total splitting of thethyroid. When, as the result of the condition for which the operation is tobe performed, thevocal apparatushas
. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. position through such anincision ; necrosed cartilaginous fragments and impactedforeign bodies may likewise be removed thereby. Ifmore room is desired than the partial laryngotomy affords,the prolongation downward of the incision through asmany of the upper rings of the trachea as is necesssarymay suffice, and is to be preferred to total splitting of thethyroid. When, as the result of the condition for which the operation is tobe performed, thevocal apparatushas already beenirretrievably dam-aged, the surgeonmay split the thy-roid cartilagethroughout itswhole extent with-out hesitation, if itmay seem desirablefn order to renderhis work more fa-cile and radical. T R A CIIEOTOMY. —Incisions of thetrachea are classi-fied according totheir relation tothe isthmus of thethyroid gland. Ifabove the isthmus,the incision is tra-cbeotomia superi-or, or the high op-eration ; if below,it is tracheotomiainferior, or the lowoperation ; if be-hind the isthmus,it is tracheotomiaor the middle opera-. wmi m Fig. 3964.—Vertical Mesial Section of Neck of Child Two Years of Age ; Isthmus of thyroid; 6, innominate artery; e, left innominate vein : dotted linesshow position of tracheal cannula in high and low operations respectively. (Modi-fied from Symington.) tor Tracheotomy.—•st ring of the tracheabeing the only one usuallyexposed above the isthmus,it is evident that sufficientroom for a satisfactory open-ing into the air-tube can begained only by drawing theisthmus down so as to ex-pose the rings behind it, orby extending the cut up-ward through the cricoidcartilage. The extent towhich the isthmus must bedepressed so as to permit theintroduction of a cannula isshown in the accompanying-life-size plate, displaying avertical mesial section of theneck of a child two years ofage. It is reproduced froma plate by Symington.*4 Thedotted outl
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
