. Diseases of the ear; a text-book for practitioners and students of medicine. fclosely to the blade is then rotatedforward and downwardthrough an angle of nine-ty degrees, and section isaccomplished by a slightsawing motion, down-ward pressure being ex-erted during the with-drawal of the the tendon is severedthe operator feels the resistance which it offered suddenlyovercome, and a sharp click is frequently heard at this mo-ment. To divide the tendon from below upward the mem-brana is punctured justbelow and behind theshort process. Upon en-tering the cavity the in
. Diseases of the ear; a text-book for practitioners and students of medicine. fclosely to the blade is then rotatedforward and downwardthrough an angle of nine-ty degrees, and section isaccomplished by a slightsawing motion, down-ward pressure being ex-erted during the with-drawal of the the tendon is severedthe operator feels the resistance which it offered suddenlyovercome, and a sharp click is frequently heard at this mo-ment. To divide the tendon from below upward the mem-brana is punctured justbelow and behind theshort process. Upon en-tering the cavity the in-strument is advanced for-ward, inward, and down-ward, the shaft remainingalmost horizontal, andthe flat surface of theblade closely applied tothe handle of the malleusuntil it has traversed thebreadth of the handle is then de-pressed, thus carryingthe curved point of the knife high up in the instrument is then withdrawn, upward pressure beingcontinually exerted and the tendon divided from below up-ward. The technique described presupposes the use of. -Tenotomy ofHartmanns tensor tympani, withknife. DIVISION OP THE ANTERIOR LIGAMENT. 495 Hartmanns tenotome, which, being sharp-pointed, is usedboth to puncture the membrane and to sever the tendon(Fig. 131.) When a blunt-pointed knife curved on the flat isused, the drum membrane is incised close to and behind thehandle of the malleus with a sharp knife ; through this open-ing the curved knife is inserted, its concavity being directedtoward the manubrium. The tendon is divided by depress-ing the handle of the knife and extending the incision upwardtoward the short process (Fig. 132.) When it seems desir-able to divide the tendonthrough an incision inthe anterior segment,the curved knife entersthe cavity somewhat be-low the short process. Itis then advanced upwardand backward, the flatsurface of the blade pass-ing closely along themanubrium and severingthe tendon as the incis-ion is extended. Wheretenotomy is
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