24 TREPHINING THE SUPERIOR MAXILLARY SINUSES 



In order to prevent aspiration of pus, blood or other fluids 

 after the perforation of the highly vascular turbinated bone, 



the a nimal mus t_be_allowed^to get up Immediately^ If_ 



under general anaesthesia, a trachea tube should be inserted 

 before beginning the operation. 



Thread a long probe with a heavy suture about 75 cm. 

 long and inserting it through the trephine opening into the 

 nasal passage, draw it out through the nostril and removing 

 the probe, attach a strip of gauze 75 cm. long to one end of 

 the suture, draw it out through the nostril and tie the ends 

 together on the side of the face to prevent dislodgement. 

 Retain the gauze in position for about forty-eight hours to 

 insure the permanency of the opening through the turbi- 

 nated bone. In case of severe hemorrhage, the nasal and 

 sinusal cavities may be tamponed for twenty-four hours 

 with a long strip of gauze which may be secured if necessary 

 by suturing to the lips of the trephine wound. In practice 

 the operation can be best carried out generally with the 

 animal in the standing position under local anaethesia. In 

 the standing position hemorrhage and the danger from the 

 aspiration of fluids is greatly lessened. 



4. TREPHINING THE SUPERIOR MAXIIiLARY SINUSES 



Figs. 3-10 



Uses. , Empyema, diseased teeth, odontomes or other 

 tumors. 



Instruments. Same as for the frontal sinuses. 



Anatomically there are two maxillary sinuses, superior, 

 SM, and inferior, IM, Figs. 3-10, separated by a thin, i^l- 

 perforate, bony partition. This partition shifts somewhat 

 in position with age and in case of disease undergoes pro- 

 found changes in locatioii. Some authors advise trephining 

 directly upon the partition in order to open the two cavities 



