Operative surgery of the nose, throat, and ear Volume 1; for laryngologists, rhinologists, otologists, and surgeons

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1917 Excerpt: ...and bronchi. (From Toldt.) in the bronchus ten sittings were required before the extraction was successful, and many of these lasted two hours. Briinings gives the time of the ordinary operation as five to fifteen minutes. Jackson has reported the removal of three tacks in three minutes. (Fig. 131.) Asepsis.--In bronchoscopy the mouth of the patient should be made as clean as possible. Jackson advises a thirty per cent solution of alcohol as a mouth wash. It goes without saying that the instru Fig. 132. Showing the relation of the main bronchi to the ribs and the chest wall (Anterior view). (From Anatomical Department, Harvard Medical School.) ments also should be clean. Generally immersion in seventy per cent alcohol is depended upon for the sterilization. Formalin vapor can be employed if preferred. The Size of the Tubes.--Briinings uses tubes of four sizes. Upper Bronchoscopy. Number Size Age 1 7 mm 1 to 3 years. IV2 7% mm 4" 5" 2 8% mm 4" 9" 3 10 mm 9 " 14" 4 12 mm Adults (men and women). Lower Bronchoscopy. Number Size Age 1 7 mm 1 to 3 years. 2 8% mm 3" 8" 3 10 mm 8 " 14" 4 12 mm Adults (men and women). BRONCHOSCOPY. In order to see the secondary bronchi the main bronchus is dislocated laterally and the tube brought into line with the bronchus to be examined. The patient's head must be bent in the proper manner to allow this change in the position of the tube. In changing the position of the head the neck should not be held far backward and cramped because this interferes with the mobility of the trachea and the bronchi. As soon as the lumen of the right main bronchus is entered and lighted by the tube, the observer sees in the distance the opening of the bronchus to the lower lobe and within this smal...