Transactions of the Section on Laryngology, Otology and Rhinology of the American Medical Associaiton at the Annual Session (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1905 Excerpt: ...purpose in view: Eestoration of the bridge of the nose and the lowering of the cartilaginous part of the nose. According to Konig, the operation consists of lowering the tip of the nose by a transverse incision at the deepest part of the depression and filling in the defect by a flap from the forehead that carries with it the outer table of bone. This is afterwards covered by a larger flap, also taken from the forehead. Israel has modified this operation, improving the cosmetic effect. He takes a flap of skin and bone from the forehead with a narrow pedicle. Secondary quadrangular flaps are formed from the skin 18. System of Practical Surgery by von Bergman and Bull., vol. i. that has been freely loosened from the nose. Helferich has modified Konig's operation in a similar way. I consider the operation as practiced by Schimmelbusch the best of all the various modifications of Konig's operation. The frontal flap is cut so that the end is very broad, containing a plate of bone wider than it is long. The narrow pedicle consists of skin only; the large defect in the forehead can be remedied by the displacement of a large curved flap from the scalp. The flap of skin and bone is not transplanted at once into its new place, but is covered with gauze and held in a horizontal position by means of adhesive plaster for several weeks until it granulates well, giving plenty of time for necrotic pieces to be cast off and for the periosteum and bone to be firmly united. The operation is completed by freshening the edges of the flap and removing the granulations. The bony plate is sawed through lengthwise exactly along the middle, so that it can be set up like the ridge of a roof, with its skin surface internally; so shaped it is transplanted into the defect. The latter is...