Fig. 311.—Loss of Nasal Bones and Partial Ulcerative Destruction of Dorsum, Lobule and Septum of Nose.
Fig. 312.—Destruction of Nasal Bones with Dorsal Integument and Lobule Intact.
Fig. 313.—Total Loss of Nose.
Many other deformities of the nose exist, of course, such as lateral deviation, twists, etc., but as in most of such cases cosmetic rhinoplastic operations and subcutaneous injection are required for their correction, inasmuch as in these cases the skin is healthy and intact, they will be considered under that part of the chapter that has to do with purely cosmetic rhinoplasty or under the chapter on subcutaneous protheses.
SURGICAL TECHNIQUE
Before going into the individual methods involved in the correction of deformities of the nose, it is well here to go into the special details required for the performance of operations about the nose proper.
Anesthesia.—It may be well here to state that many of the smaller or cosmetic operations can and should be done under local anesthesia, and that the anterior nares should be plugged to prevent the blood from running into the pharynx, but in operations of greater extent the posterior nares should be plugged by Bellocq or other method, and that since the patient must be placed under a general anesthetic, some special plan must be followed to give the same.