Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
The pins should not be withdrawn until the nose has healed into its new
position, or begin to cause irritation of the parts punctured.
Where the deviation is unilateral it should be corrected by subcutaneous
injection, as previously described.
UNDUE PROMINENCE OF NASAL PROCESS OF THE SUPERIOR MAXILLARY
The protuberance of bone lies external to the middle meatus, involving
an abnormal convexity of the nasal process of the superior maxillary.
Its external removal or reduction involves considerable tissue and would
leave a conspicuous linear scar, therefore the surgeon must attempt its
reduction from the inner nose.
The author prefers to make a horizontal incision below the inferior
border of the process, beginning anteriorly just before the articulation
with the nasal bone and extending backward as far as the view from the
nare will allow.
Through this opening, the skin overlying the bone is raised by dull
dissection. A fine nasal saw is next introduced through the submucous
wound and several vertical incisions are made into or even through the
bone about three sixteenths of an inch apart, dividing the convexed
osseous tissue into several sections adherent at their superior extremity
which lies inferior to the insertion of the levator labii superioris
alæque nasi muscle.
A forceps, such as Adams’s, is now introduced and each section of bone
thus made is fractured from below upwards inwardly to produce a concavity
of the osseous tissue.
The operation requires considerable dexterity. The amplitude of the
sawing movement is very much restricted, because of the palpebral
muscular attachment just above.
A frail bone cutting forceps may be employed and the lower half of
the process be removed to avoid encroachment upon the middle meatus,
but this is rarely necessary, as that chamber is found unusually wide
in this case. If the bone is removed, the remaining bone may be cut
into sections, as described, or by the cutting forceps, and fractured
backwards as described.
Retention dressings must be resorted to, to keep the fragments of the
bone in their new position until cicatrization has been sufficiently
established to keep them in place.
When possible Roe advises sawing off the convexity submucously and, after
loosening the skin over the dorsum of the nose, to move the bony plate
thus made over to the opposite side of the nose and into the concavity
usually found there in these cases. If there be no deviation at the
latter site the bone plate can be entirely removed through the inferior
wound in the mucosa.
CHAPTER XVII
ELECTROLYSIS IN DERMATOLOGY
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account