Fig. 438
Fig. 439
Fig. 440
Fig. 441
Sliding rectangular flaps into desired position.
It is often necessary to intermit the anesthetic because the operator must displace the mask in order to do his work. Souchon advises an apparatus by which most of this delay can be avoided. By means of a rubber bulb a current of air is passed through the bottle containing the anesthetic and then directed through a tip which is passed down in the pharynx through a nostril. This may be connected, if so desired, with a bag of nitrous oxide gas, which is illustrated in [Fig. 442], and its use in [Fig. 443].
Ligation with excision of a section of the external carotid has been suggested by Dawbarn as a means of cutting off the blood supply in cases of inoperable malignant tumors of the face, thus reducing their rate of growth. In tumors of the jaw, for instance, he would also tie the inferior dental artery, with its mylohyoid branch, just before it enters the inferior dental canal. He advises, also, the removal of one inch of the inferior dental nerve, thus avoiding pain and distress, occluding the artery on the less diseased side first, waiting for two or three weeks before attacking the more diseased side, for should there be noticeable benefit after operation on the more affected side many patients would be unwilling to be again subjected to the other operation. Other operations include those made upon the various nerves for relief of neuralgia or for nerve suture of divided trunks. These have been described in a previous chapter.
Fig. 442