Intrinsic Cancer of the Larynx and the Operation of laryngo-Fissure With a Description of some New Instruments Specially Designed for Improving the Technique
The Journal of Laryngology Rhinology and Otology
The muco-periosteum is freed upwards and the lower portion of the superior maxilla laid bare. An opening is made through the bone by gouge and mallet and enlarged if necessary with bone forceps. The contents of "the antrum can then be readily examined and dealt with under direct vision. The lower and anterior part of the inner bony wall of the antrum is then removed, exposing the nasal muco-periosteum. A horse-shoeshaped flap of this muco-periosteum is next turned down into the antral cavity,
... us making a free counter-opening into the anterior part of the inferior meatus. In order to facilitate the introduction of a cannula for subsequent lavage of the antrum, the anterior portion of the inferior turbinate •covering the counter-opening is removed. The gingivo-labial incision is then closed with a few catgut sutures ; no packing is left in the antrum. The after-treatment consists merely of daily lavage of the antrum for a week or two. RESULTS. The results after the radical operation have been uniformly good. The patient has been immediately relieved of nasal obstruction, and any nasal discharge has cleared up after daily lavage for a week or two. Eecurrence, even after the radical operation, has occurred in an occasional case. This has been found to be probably due to insufficient removal of the affected mucosa. Owing to the difficulties consequent upon the war, it was not considered advisable to ask patients living in the country to report themselves for re-examination. Four cases presenting themselves at the Department at periods of one, three, four, and five years after the radical operation, were found to be free from any inconvenience or evidence of recurrence. In conclusion, I wish to tender my thanks to Mr. Logan Turner for his kind permission to make use of the clinical records of his department, and also to Dr. J. S. Eraser for his kind assistance.