File:Buffalo medical and surgical journal (1888) (14590341768).jpg

Identifier: buffalomedicalsu2818unse (find matches)
Title: Buffalo medical and surgical journal
Year: 1889 (1880s)
Authors:
Subjects: Medicine General Surgery
Publisher: Buffalo : Joseph Warren & Co., Printers
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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nents fist, falls from a horse or carriage, and injuries 714 CROOKED AND OTHERWISE DEFORMED NOSES. received while playing ball, are not infrequently the disfiguringtraumatism. We may also have deformity due to wounds madeby cutting instruments, whereby portions of the soft structureshave been lost, or to unseemly cicatrization after such wounds.Syphilis, giving rise to necrosis and ulceration of the bones andcartilages, thereby allowing the bridge of the nose to fall in, orother changes to take place, is a potent cause of nasal deformity.Ulceration of the alae of the nose due to syphilis, while in theearly stage necessitating active treatment, may later requiresurgical operation to reconstruct the lost part. Again, in epithe-lioma it may be necessary to cut away the ala and at once makea new structure. It may, at other times, be necessary to make anew tip to the nose after such an excision for malignant disease.By looking at a skull it is seen that if the septum and nasal Fig. i. a be
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a. Saddle-back Nose. b. Tuberous Nose. c. Aftgular Nose. bones are destroyed by syphilis, there is a great tendency for thebony arch, or bridge, to sink in and allow the tip of the nose toturn up ; thus leaving only the small prominence formed by thewings and lobe of the nose, and causing great disfigurement ofthe front part of the face. Again, you may have lateral open-ings in the nose following specific ulceration. I have underobservation at the present time a patient with an opening due to CROOKED AXD OTHERWISE DEFORMED XOSES. 715 syphilitic ulceration, who has not yet agreed to an operation, butwho will possibly do so in time. I have drawn here a number of badly-shaped noses, whichcan be remedied by operation. We may have a nose thatsinks in at the top, in which there is not much bridge. This isgenerally due to want of proper development of the bones andcartilages forming the septum, and is sometimes called the sad-dle-back nose (Fig. 1, a). A similar nose is often found ininherit

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