It may be proper, in this place, to spend a few words upon el...
Vegetables Green And Fruit
We would strongly recommend our readers to continually have th...
Fancy can save or kill; it hath closed up wounds, when t...
See Paralysis. ...
The Distinctive Diagnosis Between External And Internal Inguinal Herniae The Taxis The Seat Of Stricture And The Operation
A comparison of the relative position of these two varieties ...
This disease, or its approach, may be known by several signs: ...
Punctures Case Ix
James Joynes, aged 12, was bitten by an ass, on each side of ...
This is a name applied to pain in the region of the heart cau...
This forms a severe feature in many cases of illness, and has ...
Few vital processes are more remarkable than that by which foo...
Where The Temperature Is Too Low That Is Below 98-2/5 Deg
rub all over with warm olive oil, and clothe in good soft flan...
No greater mistake could be made than to curtail the hours of ...
Declining Limb A
See Limbs, Drawn up. ...
From The Hygienic Dictionary 2
Toxemia.  "Toxemia is the basic cause of all so-called dise...
The surface of the body should be kept clean, as far as possi...
Is a most valuable aid to health, acting as a physical and men...
Training For Motion
"IN every new movement, in every unknown attitude nee...
The Triviality Of Trivialities
LIFE is clearer, happier, and easier for us as things assume ...
The Surgical Form Of The Deep Cervical And Facial Regions And The Relative Position Of The Principal Bloodvessels And Nerves
While the human cervix is still extended in surgical position...
The Relation Of The Principal Bloodvessels Of The Thorax And Abdomen To The Osseous Skeleton Etc
The arterial system of vessels assumes, in all cases, somewha...
Category: CHRONIC STENOSIS OF THE LARYNX AND TRACHEA
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Bilateral abductor laryngeal paralysis causes severe
stenosis, and usually tracheotomy is urgently required. In cadaveric
paralysis both cords are in a position midway between abduction and
adduction, and their margins are crescentic, so that sufficient airway
remains. Efforts to produce the cadaveric position of the cords by
division or excision of a portion of the recurrent laryngeal nerves,
have been failures. The operation of ventriculocordectomy consists
in removing a vocal cord and the portion or all of the ventricular
floor by means of a punch forceps introduced through the direct
laryngoscope. Usually it is better to remove only the portion of the
floor anterior to the vocal process of the arytenoid. In some cases
monolateral ventriculocordectomy is sufficient; in most cases,
however, operation on both sides is needed. An interval of two months
between operations is advisable to avoid adhesions. In almost all
cases, ventriculocordectomy will result in a sufficient increase in
the glottic chink for normal respiration. The ultimate vocal results
are good. Evisceration of the larynx, either by the endoscopic or
thyrotomic method, usually yields excellent results when no lesion
other than paralysis exists. Only too often, however, the condition is
complicated by the results of a faultily high tracheotomy. A rough,
inflexible voice is ultimately obtained after this operation,
especially if the arytenoid cartilage is unharmed. In recent bilateral
recurrent paralysis, it may be worthy of trial to suture the recurrent
to the pneumogastric. Operations on the larynx for paralytic stenosis
should not be undertaken earlier than twelve months from the inception
of the condition, this time being allowed for possible nerve
regeneration, the patient being made safe and comfortable, meanwhile,
by a low tracheotomy.
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