File:A manual of operative surgery (1910) (14589804938).jpg

Identifier: manualofoperativ0002trev (find matches)
Title: A manual of operative surgery
Year: 1910 (1910s)
Authors: Treves, Frederick, Sir, 1853-1923 Hutchinson, Jonathan, 1859-1933
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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most of them in-genious and all more or less complex, have been designed torepair defects of the nose. The defect may be due to congenitaldeformity, or may depend upon injury, or upon the results oflupus, syphilis, or other destructive forms of ulceration. Anyoperation is contra-indicated in the case of partial or completeloss of the nose, the result of cancer. The main flaps out of which the new organ is formed may be CHAP. IV) RHINOPLASTY 117 derived from the forehead, the cheek, the arm, or forearm. Itis seldom that the whole of the nose is destroyed, and it will beevident that the least successful results follow in cases in whichthe bony parts of the nose have been lost. In complete rhinoplastic operations it is assumed that thewhole of the cartilaginous part of the organ, including the tip,the columna, the alae, and more or less of the septum, is lost. Partial rhinoplasty concerns itself with slighter defects, andis employed to replace the tip of the nose, or one ala, or part of
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FIGS. 243, 244.—KEEGANS METHOD OF PERFORMING RHINOPLASTY: PORTRAITS OF THE same patient before and AFTER operation. (From the Lancet, Feb. 21st, 1891.) the septum, or to close a fistulous opening in the skin of themember. Many of these minor operations are very successful, butmany of the procedures which aim at the restoration of theentire nose do not give brilliant results. Among the most excellent results obtained by rhinoplastymust be placed the very admirable series of cases published bySurgeon-Major Keegan in the Lancet for Feb. 21st, 1891. (SeeFigs. 243, 244.) In cases in which the bony framework of the nose has beenlost, or in which the patient is the subject of a depressednose —as in congenital syphilis—the results are almost entirelyunsatisfactory. An unsightly gap in the face may be closed inthe one case, it is true, but it will be covered in by a flap of skin n8 OPERATIONS ON HEAD AND NECK (part hi which is in time level with the cheek. In the case of the de-pressed n

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