Fig. 447. Fig. 448.
Author’s Method.
Denonvillier Method.—The operation is similar to that of Dieffenbach and the author’s modification just mentioned. Its advantage, as in the latter, is that the inferior border or nasal rim remains intact, and contains what cartilage remains above the defect. The shape of the incision is as shown in [Fig. 449].
The flap A, B, C includes the skin and such cartilage as can be used, while the rim below the line B, D retains its lower cicatricial border.
The flap is slid down until the defect has been overcome, and the resultant superior triangular wound is allowed to heal by granulation. The dissection of the flap is made down to the line including the skin or cartilage referred to. At the dotted line B, D the whole thickness of the tissue except the overlying skin is involved.
Fig. 449.—Denonvillier Method.
Von Hacker Method.—The flap A, F, C, as shown in [Fig. 450], is cut from the entire thickness of the side of the nose attached by its posterior pedicle C.
This flap is moved downward, and its anterior border is sutured along the freshened line A, B, as in [Fig. 451], leaving a triangular defect, A, F, C.