76 



TA'ACHEOTOMY 



This method has the advantage over Chabert's that for 

 the removal of hard contents (chondroids) the opening can 

 be readily dilated, even to such an extent that the entire 

 hand may be passed into the air sac and the opening of the 

 Eustachian tube be explored as in Yiborg's operation. 



12. TRACHEOTOMY. 

 Fig. 2. 



Instruments. Razor, scissors, convex scalpel, tenacula, 

 tenaculum and ligation forceps, trachea tube, and suture 

 material. 



Technic. In the superior third of the cervical region, 

 in the neighborhood of the fourth to the sixth tracheal ring, 

 shave and disinfect the skin on the anterior surface of the 

 neck to the extent of lo cm. long by 5 cm. wide. The 

 operation is best performed upon the standing animal with 

 the head extended. In lateral decubitis the operation is 

 carried out with some difficulty, and generally the operator 

 fails to get the incision on the median line. The operator 

 stands before the right shoulder of the horse with an 

 assistant opposite him. 



Render the skin tense along the median line of the 

 trachea with the left hand and then make a drawing cut 5 

 to 8 cm. long from above to below with the scalpel. The 

 incision should be made carefully upon the median raphe of 

 the skin which is virtually destitute of sensation and requires 

 no anaesthesia. After the skin muscle is cut through, in 

 order to avoid hemorrhage, separate the two sterno-thyro- 

 hyoideus muscles by means of tenacula along the median 

 raphe in the white strip of connective tissue. The opening 

 into the trachea may be made in a variety of ways. The 

 quickest and most crude method is to slit it from above 

 downwards through two or three tracheal rings, and press- 



