Lectures on certain diseases of the jaws : delivered at the Royal College of Surgeons of England, 1887 / by Christopher Heath, F.R.C.S.

  • Christopher Heath
Date:
[1888?]
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on certain diseases of the jaws : delivered at the Royal College of Surgeons of England, 1887 / by Christopher Heath, F.R.C.S. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    projecting from the temporal bone. The result was quite satisfactory. A similar operation, but performed by a different method^ was successfully undertaken by Dr. Kobert Abbe, of New York, in a boy aged ten, who had suffered from otitis media and suppuration of the joint some years before. A vertical incision was made in front of the ear, and a horizontal one meeting its upper end was carried along the lower border of the zygoma. The parotid, with the facial nerve, was drawn down, and with a periosteal elevator the posterior fibres of the masseter were cleared away, and the articulation exposed. A narrow osteotomy chisel was now applied to the neck of the condyle, and carefully driven half through the bone, and by forcibly opening the mouth the bone was broken through. The neck of the condyle was then removed piecemeal, but the condyle was left in situ. The result was satisfactory. Sedillot mentions that in a case of true ankylosis of the tem- poro-maxillary articulation, M. Grube, in 1863, carried a straight chisel through the mouth to the neck of the jaw, which broke by hammering. Some months later, he divided the masseter subcutaneously, and the cure, by the formation of a false joint, was permanent. In 1879 1 performed the same operation in a child aged six, but the results were un- satisfactory. Suppuration was set up, and required an external opening, and the movement, which was free at first, became as limited as before the operation, and I subsequently excised the] condyle. It would appear, therefore, that mere division of the neck of the bone does not offer such good prospect of a permanent false joint as removal of the neck or the condyle, though these operations are necessarily more severe. Esmarch's operation of removing a wedge in front of the masseter is as applicable to cases of ankylosis from disease of the joint! as to cases of cicatrix, and Fischer (Archiv. fiir Klin. Chirurgie, Bd. xiii., Hft. 3) appears to have performed the operation on both sides of the jaw, in a case of bilateral ankylosis of the temporo-maxillary articulation, with very
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