File:Diagram of intra- and extracranial venous anastomosis (A Text-Book on Diseases of the Ear, Nose and Throat, Plate 6) (1901).jpg

Identifier: textbookondiseas00burn (find matches)
Title: A text-book on diseases of the ear, nose and throat
Year: 1901 (1900s)
Authors: Burnett, Charles H. (Charles Henry), 1842-1902
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Publisher: Philadelphia and London, J. B. Lippincott company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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eur, but never with a chisel and hammer. The rongeurused for this purpose should be as broad as possible at its beak. Themost accessible part of the sigmoid groove for opening is the knee anddescending portion below it. The knee lies about at the level of the suprameatal spine, and usuallyfrom one-half to two-thirds of an inch posterior to it. If the mastoid ismarkedly prominent and convex, it is then what is known as a dan-gerous mastoid, because the groove for the sinus will be found to besuperficial,—ie., near the posterior wall of the external auditory canal,—while when the mastoid process is broad and flat, the sinus usually liesquite far behind the posterior wall of the external auditory canal. Afterthe groove of the sinus is opened, further exposure of the sinus eitherway is best accomplished with a rongeur, the chisel and hammer beingused only to remove the outer table of the skull, which is too thickto be removed by means of the rongeur. All carious bone must be PLATE YT.
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Diagram of intra- and extracranial venous anastomosis. (Mace-\ven.) OTITIC PHLEBITIS, THEOMBOSIS, AND PY-.EMIA. 207 removed, no matter how far such interference may lead. Operation on thesigmoid sinus cannot be jDroperly performed if less than two inches ofits bony covering be removed. As much as this should be removedTvhether the bone is diseased or not throughout this length, Chipault and Lambotte ^ have removed the bone and the sinus, afterligation of the jugular, from the bulb to the torcular, the patient recov-ering entirely. Downward, it will serve all purposes to remove thegroove as far as and including the external margin of the jugular fora-men, great care being taken to avoid the posterior condylar foramen be-hind and the lower third of the Fallopian canal in front. In most instancesthe thrombus is situated in the descending portion of the sigmoid sinus Fig. 8Cy.

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