. The Journal of laryngology and otology. Hallesletter to me. The method formerly proposed by me I still think good, butI have greatly imj)roved the procedure. It has, up to now, notbeen made public. ^ Laryngoscope, September, 1913, p. 13. May, 1914. Rhinology, and Otolo§fy. 241 An incision is made through the mucosa and periosteum oqthe agger nasi, immediately in front of the middle turbinal,beginning as high up as possible and descending along the frontaledge of the turbinal to end in the middle meatus close to the headof the inferior turbinal. From the upper end of the incision thecut is ca
. The Journal of laryngology and otology. Hallesletter to me. The method formerly proposed by me I still think good, butI have greatly imj)roved the procedure. It has, up to now, notbeen made public. ^ Laryngoscope, September, 1913, p. 13. May, 1914. Rhinology, and Otolo§fy. 241 An incision is made through the mucosa and periosteum oqthe agger nasi, immediately in front of the middle turbinal,beginning as high up as possible and descending along the frontaledge of the turbinal to end in the middle meatus close to the headof the inferior turbinal. From the upper end of the incision thecut is carried by the lateral nasal wall as far as the nasal bridge,and thence descending in a curve to end in the vicinity of theupper edge of the inferior turbinal. The resulting flap is detachedfrom above downwards and is turned back and held by a smallpledget under the middle turbinal. Now the edge of the middleturbinal is detached and after that the agger narium is chiselledaway. One may chisel laterally rather far without the least Fig. 12.—Diagram showing muco-periosteal flap employed by the author. In this way the foremost ethmoid cells are laid bare; the ethmoidbone is now cleaned with suitable instruments. By this processone can, anyhow in all suitable cases examined by me up to now,introduce a probe into the frontal cavity with the greatest is—I always lay great stress on the point—the preliminarycondition for intranasal operation, should the opening alreadyobtained not suffice. In the latter circumst;inces the openingadmits my smallest pear-shaped burr with blunt, rounded top; itonly cuts when led downwards. The floor of the fi-ontal sinus isnow burred away, first with small and then with larger burrs. Thecavity is exposed widely, and one can not only see into it, but probeit thoroughly, and, if necessary, remove the diseased mucosa entirelywith my sharp, pliable spoons. The great advantage of the presentmethod is that one can avoid the sharp burr
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