File:Sajous's analytical cyclopædia of practical medicine (1904) (14778360432).jpg

Identifier: sajoussanalytica01sajouoft (find matches)
Title: Sajous's analytical cyclopædia of practical medicine
Year: 1904 (1900s)
Authors: Sajous, Charles Euchariste de Médicis, 1852-1929
Subjects: Medicine Medicine -- Practice
Publisher: Philadelphia : F.A. Davis Co.
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: MSN

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son. In theory, the hypophysis may bereached, according to Toupet, either byan intracranial or by an extracranialroute. Those who favor the intracranialmethod advance as their chief argumentthe less danger of infection to which thepatient is subjected, and propose eitherthe frontal route (Krause, Kiliani) orthe temporal route, already employedin their experiments by Caselli andHorsley. At the present writing (1918) thechief indication for operation is to re-lieve the pressure of the growth onsurrounding important structures.Hence the term decompression oper-ation now extensively used. Thetumor may be partially removed, orspace in neighboring structures oflittle importance mav be provided to ACROMEGALY (LAUNOIS AND CESBRON). 307 accommodate it if it cannot 1)e re- especially thin in most instances. moved. The tumor may itself alter greatly Special precautions are necessary the shape of the sella and erode its when an operation is to be resorted to. walls sufficiently to penetrate it. A
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The pituitary, marked with a white cross, can be seen in its dorsal sheath. (U. Proust.) Both the sphenoidal cells and the radiograph will furnish an outline of sella turcica vary greatly in size, the sella and afford a pretty correct depth, shape and thickness, the pos- estimate of the size and location of terior of the sphenoidal sinus being the growth. 308 ACROMEGALY (LAUNOIS AND CESBRON). A trained brain surgeon should beentrusted with the operation. Someprefer general anesthesia, others localanesthesia, a strong solution of cocain(20 per cent, solution) with adrenalinbeing used. In the United States two methodshave proven fairly satisfactory. TheHirsch-Cushing submucous nasalmethod and the fronto-orbital methodof Frazier. In the Hirsch-Cushing operationintra-tracheal anesthesia is employed.The upper lip is raised and a shortincision made down to the anteriornasal spine of the superior maxilla,the soft parts scraped back until thecartilaginous septum is exposed, andthe septal memb

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