Rhinoplastic operations : with some remarks on the autoplastic methods usually adopted for the restoration of parts lost by accident or disease / by J. Mason Warren.

  • Warren, Jonathan Mason, 1811-1867.
Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: Rhinoplastic operations : with some remarks on the autoplastic methods usually adopted for the restoration of parts lost by accident or disease / by J. Mason Warren. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    17/40
    forced the patient to cry out. But what was much more troublesome still, was Its being repeatedly received in the eyes of the operator, so as once or twice to oblige me to discontinue the operation for the space of some seconds. The difficulty which the author here complains of, was remedied in the present instance by a very simple means. Instead of placing the patient in an upright position, he was made to lie upon his back on a table, the operator standing behind him ; the blood was thus conducted off on each side of the face, instead of passing over the nasal fossa and mouth, and entering the throat. To guard against any possibility of this accident taking place, plugs were confined in the opening of the nasal cavities, during the dissection of the flap, and the time occupied in closing up the wound on the forehead. When the operation was commenced around this opening, and the entrance of the blood was unavoidable, the patient, who maintained sufficient coolness throughout, was requested to keep the blood as long as possible in the mouth, and an assistant directed to clear out, with a small sponge, what had collected, as occasion required. We give the account of another trouble, in the author's own lively description, which, fortunately, was avoided in the present instance. But an accident of much more gravity, and which placed me in a very critical position, presented itself at a moment, when, after having detached from the forehead the flap of integument, I was about to bring it down into the place it was destined to occupy. Previous to making this twist of the new flap, it was thought necessary, as I have before stated, to prolong the incision on the left side as far as the medium line of the root of the nose, in order to facilitate the torsion of the pedicle; the patient experienced, at this moment, such a violent pain by the inevitable division which it was necessary to make of some of the ramifications of the frontal branch of the oph- thalmic nerve of Willis, that he escaped from the hands of the as- sistants, rushed towards the door, and was determined not to undergo the remaining part of the operation. At this moment, his physiog- nomy presented a most frightful aspect; his forehead covered by a large wound, the borders of which, retracted by pain, had greatly augmented its extent, and all the rest of the face, his neck, and gar- ments, inundated with blood. But a sight which was much more horrible to behold was the flap of palpitating integuments, which at every moment were jerked from one side of the face to the other. In the present instance, no particular suffering was observed by