Basal hernias of the brain / by Christian Fenger.

  • Christian Fenger
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Basal hernias of the brain / by Christian Fenger. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The difficulty in operating lies in the inaccessibility of the pedicle at a point close to its exit from the cranium. The more posterior the point of exit, the greater the difficulty of the operation. Various preparatory operations are required in the treatment of hernias whose pedicles are situated in different parts of the nose. Liga- tion and transfixion require much more operating space for manipulation than does simple division of the pedicle. The anterior third of the nasal cavity can be reached, as in Czerny’s case, by longitudinal division of one nostril, or by Ollier’s method of temporary transverse osteoplastic resection of the nasal bones and septum at the root of the nose, or by Bruns’ lateral osteoplastic resection of the nasal bones and septum. If the pedicle is located in the anterior part of the middle third of the nose, Annandale’s operation, which has already been mentioned, may give sufficient space for manipulation. If it is located in or just anterior to the posterior third of the nasal cavity, Von Langenbeck’s resection of the superior maxilla, as practised in my case, will be required. If, however, the pedicle should be found to be located in or behind the posterior nares, I am of the opinion that nothing short of total extirpa- tion of the superior maxilla will furnish the space necessary for operating, and it is a serious question whether a tumor in this location should be removed, when its extirpation would entail so great a sacrifice. 269 La Salle Avenue. Bibliography. 1. Abraham: British Medical Journal, February 9, 1889. 2. Bruns: Chirurg. Atlas. Tubingen, 1860, Abtb. I., Plate XII., Fig. 12. 3. Dupuytren: Legons Cliniques. 4. Fenger: Basal Hydrencephalocele, Removal by Osteoplastic Pesection of Superior Maxilla. Exhibition of Specimen and Patient. Chicago Medical Record, April, 1892, p. 157. 5. Giraldes: Legons Cliniques, etc., 1869. 6. Heinecke, W.: Die chirurgischen Krankheiten des Kopfes. Stuttgart, 1882. Billroth and Luecke’s Deutsche Chirurgie.Lief. 331, p. 224. 7. Huguenin: Der chronische Hydrocephalus. Ziemssen’s Handb. d. spec. Pathol, u. Tlier., Lief. 33, p. 85. Leipzig, 1880. 8. Kelsch: Otto, cited by Spring from Larger. 9. Klimentowsky: Moskow. med. Zeit., 1868. 10. Klintosch, J. T.: Cited by Larger. 11. Larger, R.: Arch. gen. de Medecine et de Chlrurgie, April, May, aud July, 1877. 12. Lichtenberg: Cited by Larger and Huguenin. 13. Otto: Cited by Spring from Larger. 14. Rippmann: Cited from v. Meyer. 15. Serres: Philos. Anat., ii. p 92. 16. Tilleux: Traite de Anat. Topograph. Paris, 1878. 17. Virchow, R.: Die Krankhaften Geschwiilste. Berlin, 1863, Band i., p. 188. 18. Volkmann: Beitriige zur Chirurgie, p. 261. 19. V. Meyer, E.: Ueber eine basale Hirnhernie in der Gegend der Lamina Cribrosa. Vir- chow’s Archiv, Band cxx., H. 2, p. 309.