For the _removal of the auditory apparatus and its examination
outside of the body_ a number of methods are advised. The temporal
bone may be resected by extending the scalp-incision half-way down
the neck along the anterior edge of the trapezius. The anterior flap
with the external ear is carried forward as far as the middle of
the zygoma and below to the angle of the lower jaw. The posterior
flap is carried backward to the middle of the occipital bone. All
soft parts are cut as closely to the bone as possible. A saw-cut
is now made across the posterior cranial fossa, beginning just
behind the mastoid process and extending to the median line of the
clivus half-way between the anterior border of the foramen magnum
and the sella turcica. The sinus sigmoideus is thus included in
the part to be removed. A second saw-cut is then made across the
middle cranial fossa, in a line nearly parallel with the transverse
diameter of the skull, cutting the middle of the zygomatic arch,
the anterior portion of the squama, the great wing of the sphenoid
and the pterygoid process, to the tuberculum sellæ. The median ends
of the two saw-cuts are then united by a chisel-cut in the median
line of the sella and clivus. All bony connections remaining are
then cut with the chisel. The soft parts are then cut, beginning
with those attached to the mastoid process; the loosened bone is
then raised and pulled anteriorly so that the posterior capsule of
the maxillary joint can be cut and the jaw-bone disarticulated. All
remaining soft parts of neck and nasopharynx are now cut and the
temporal bone with the complete ear-apparatus and neighboring portion
of nasopharynx is removed. When both temporal bones are removed the
saw-cuts should not be carried to the median line, but should stop
at the borders of clivus and sella, and then united on each side by
sagittal chisel-cuts made along these borders, leaving the clivus
and sella as a firm connecting bridge between anterior and posterior
portions of the skull. The resected bone may now be examined by means
of a saw-cut made perpendicularly through the apex of the eminence
of the superior semicircular canals and parallel with the crista of
the petrous bone. The tegmen should be removed before the saw-cut is
made and the covering of the tympanic cavity and the outer wall of
the external auditory canal also removed. The tendon of the tensor
tympani is cut and the anvil-stapes articulation severed so that the
saw-blade passes between the drum, hammer and anvil on one side and
the head of the stapes on the other without damaging or displacing
the ossicles. This can be accomplished by pushing outward the drum
with hammer and anvil so that the saw-blade can pass between the
anvil and the head of the stapes. The bone should be held in a vise
and a fret-saw used. On one side of the cut will be seen the drum,
hammer, anvil and anterior portion of the mastoid cells; on the other
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