7. =Examination of Nose and Neighboring Cavities.= Of all the methods
advised for the examination of the nasal cavities the method of
_Harke_ (Fig. 32) is the easiest and gives the best views of the
nasal tract. After the brain has been removed the scalp incision
is carried downward to the middle of the neck on both sides,
following the anterior edge of the trapezius, as for the removal
of the temporal bone. The anterior flap is then carried forward
as far as the bridge of the nose and the edges of the orbits, and
the flap pulled down over the face. The posterior flap is carried
back as far as the upper cervical vertebræ, removing the muscles
with the scalp. The head of the cadaver is now raised and firmly
held by an assistant or clamped in a head-holder; and with the
large meat-saw the occipital bone is sawed through in the median
line, cutting first the squama and then the clivus. The saw is then
set anteriorly into the frontal bone, to the left or right of the
septum, in order not to injure the septum narium. (Fig. 32.) The
sawing then proceeds through the sella turcica, body of the sphenoid,
ethmoid and frontal bones until the base of the skull is divided
into halves. The cartilage-knife is then introduced through the
foramen magnum and the basal ligaments cut. The right and left sides
of the skull posteriorly are then taken in the two hands and with
a quick, powerful tug forced outward until the nasal bones, hard
palate and alveolar processes break apart. The two halves of the
base of the skull then open like a book, turning on an axis, running
through the inferior maxillary articulation and the occipito-atloid
ligaments. If there is too great resistance in the region of the
foramen magnum, the anterior and posterior arches of the atlas may
be cut with a chisel. The sphenoidal sinus, septum narium, frontal
sinus and the nasal cavity on one side of the septum with the
nasopharynx are thus exposed, and their walls and contents may now be
examined. Material for bacteriologic examination should be secured
before further cutting is done. The septum may then be removed with
forceps and scissors, the nasal cavity on the other side examined,
the nasopharynx inspected, and the antrums opened with small
bone-forceps. After the examination is complete the halves of the
base are brought together and fastened with copper wire anteriorly
and posteriorly, taking care that the anterior wire will not be
visible through the skin of the forehead.
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