Results. Stenosis of the passage from the naso-pharynx to the meso-pharynx, caused by syphilitic adhesions between the soft palate and the posterior pharyngeal wall, is one of the most difficult affections in this neighbourhood to operate on with satisfactory results. The cause of disappointment lies in the low vitality of specific scars and their well-known tendency to contract.
Surgical measures are sometimes required for the damage left by syphilis during the healing process.
The saddle-back deformity of the external nose is best corrected by subcutaneous injection of paraffin (see Vol. I, p. 681).
Perforations in the hard or soft palate may require operation to close them (see Vol. I, p. 717).
OPERATIONS FOR TUBERCULOSIS
Tuberculosis only occurs in the nose in the mitigated form of lupus. Surgical interference is frequently called for, generally in the form of curettage or the application of caustics.
The most satisfactory caustic is the galvano-caustic point, applied under cocaine, and at repeated sittings.
Curettage is required in more advanced cases. Chloroform is always required. Not only should all soft and diseased tissue be scraped away with a Volkmann’s spoon, but the curettage should be carried on vigorously until a healthy and resistant area has been reached. It is rare for too much tissue to be removed, whereas recurrences are only too frequent.