. The Journal of laryngology and otology. July, 1913.] Rhinology, and Otology. 3G3 Central Nasal—/. e. Septal Routes. A. Endo-nasal Method. ** (1) The Killiau-Hirsch method : Commeuciug with Killiausresectiou of the septuui, followed bv resection of the anterior walls andseptum of the sphenoidal sinuses + removal of the floor of the sella turcicaoriginated and carried out many times (Hirsch, and later by Hill once). B. External Rhinotomic Methods. ** (2) Enlargement of one anterior uarial opening by an anteriorincision forwards and upwards, followed by the Killian-Hirsch operation(Graham). **
. The Journal of laryngology and otology. July, 1913.] Rhinology, and Otology. 3G3 Central Nasal—/. e. Septal Routes. A. Endo-nasal Method. ** (1) The Killiau-Hirsch method : Commeuciug with Killiausresectiou of the septuui, followed bv resection of the anterior walls andseptum of the sphenoidal sinuses + removal of the floor of the sella turcicaoriginated and carried out many times (Hirsch, and later by Hill once). B. External Rhinotomic Methods. ** (2) Enlargement of one anterior uarial opening by an anteriorincision forwards and upwards, followed by the Killian-Hirsch operation(Graham). ** (3) Vertical fissure of the tip of nose and columella, followed bvthe Killian-Hirsch operation (G-raham). (Transverse fissure of coluiunellaalone suggested by Kanavel.) Hematoma beneath capsi/teof Tumour Speculum. •jV Post. AccessorySinus Ant^ wall of Sellarfo3Ss removed AntC wall of SphenoidalSinus remoi/ed Fig. 1.—Diagram bj- Dr. Hill of the endonasal decompression operation.(Killian-Hirsch methodi performed by him on Dr. Leonard Williamsspatient. Post mortem a post-operative hcematoma was found and also anaccessory air sinus in the basi-sphenoid. The Killian speculum shouldhave blades 9 cm. long in order to reach the sphenoidal sinuses. Thealternative auxiliary incisions used by Mr. Graham are indicated by dottedlines G G and ^f g ; the latter, in cases of narrow noses, can be extendedupwards slightly to the left of the mid-line as far as the root of the nose,the nasal bone divided, and half the external nose turned to the left as anosteoplastic flap (Linharts rhinotomy). (4) Lariches external transverse naso-labial incision with upwarddisplacement of the cartilaginous external nose, followed by septalI resection, etc. (Kanavel, Mixter). * (5) Sublabial oral incision (a min
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Keywords: ., bo, bookcentury1800, booksubjectear, booksubjectnose, bookyear1887
