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The patient should be placed in the recumbent position, with...
Fatty degeneration of the heart muscle may be caused by acute...
This is a name applied to pain in the region of the heart cau...
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 ...
It is rarely, if ever, advisable to use alcohol. In certain ...
Inflammation Of The Finger Case Xxxii
Miss B. aged 23, had a slight scratch on the inside of the in...
Foreign Bodies In The Air And Food Passages
The air and food passages may be invaded by any foreign subst...
See Dropsy. ...
Action Of The Sitz-bath Explained
The _sitz-bath_ acts in a direct manner upon the abdominal or...
WHEN we face the matter squarely and give it careful ...
Mineral Acids Muriatic Acid Prescriptions
have also been used with good effect in some epidemics. _Muri...
Technicalities Of The Pack And Bath
Let me give you its technicalities, and the rationale of its ...
See Rash. ...
Punctures Case Iii
A female servant punctured the end of the finger by a pin; th...
Tests Of Heart Strength
If both systolic and diastolic blood pressure are taken, and ...
Breast With Corded Muscles
Often a slight hardness shows itself in a woman's breast, when...
under a well conducted course of hydriatic treatment is, in g...
Instruments For Direct Laryngoscopy
In undertaking direct laryngoscopy one must always be prepar...
Influenzal infection, not always by the same organism, sweep...
If a chronic endocarditis has followed an acute condition, so...
Taking A Laryngeal Specimen For Diagnosis
Category: DIRECT LARYNGOSCOPY 2
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The diagnosis of
carcinoma, sarcoma, and some other conditions can be made certain only
by microscopic study of tissue removed from the growth. The specimen
should be ample but will necessarily be small. If the suspected growth
be small it should be removed entire, together with some of the basal
tissues. If it is a large growth, and there are objections to its
entire removal, the edge of the growth, including apparently normal as
well as neoplastic tissue, is necessary. If it is a diffuse
infiltrative process, a specimen should be taken from at least two
locations. Tissue for biopsy is to be taken with the punch forceps
shown in Fig. 28 or that in Fig. 33. The forceps may be inserted
through the tube or from the angle of the mouth; the extubal method
(see Fig. 58).
[FIG. 58.--Schema illustrating removal of a tumor from the upper part
of the larynx by the author's extubal method for large tumors. The
large alligator basket punch forceps, F, is inserted from the right
corner of the mouth and the jaws are placed over the tumor, T, under
guidance of the eye looking through the laryngoscope, L. This method
is not used for small tumors. It is excellent for amputation of the
epiglottis with these same punch forceps or with the heavy snare.]
Removal of large benign tumors above the cords may be done with the
snare or with the large laryngeal punch forceps. Both are used in the
Amputation of the epiglottis for palliation of odynophagia or
dysphagia in tuberculous or malignant disease, is of benefit when the
ulceration is confined to this region; though as to tuberculosis the
author feels rather conservatingly inclined. Early malignancy of the
extreme tip can be cured by such means. The function of the epiglottis
seems to be to split the food bolus and direct its portions laterally
into the pyriform sinuses, rather than to take any important part in
the closure of the larynx. Following the removal of the epiglottis
there is rarely complaint of food entering the larynx. The projecting
portion of the epiglottis may be amputated with a heavy snare, or by
means of the large laryngeal punch forceps (Fig. 33).
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