60 THE ROARING OPERATION 



cloth, or a thin layer of absorbent cotton into the ventricle. 

 The naked soft rubber burr zvill not securely grasp the •ventric- 

 ular mucosa, but when wrapped with absorbent cotton or with 

 cheesecloth, and the ventricle properly cleansed of mucus, the 

 burr grasps the mucosa promptly afid firmly. While the 

 metal burr, at one time used, grasps the mucosa well, it has a 

 great tendency to tear and mutilate it and most of ail.it not 

 infrequently wounds the perichondriutn and induces a chon- 

 dritis which causes the operation to fail. Press the burr 

 gently against the bottom of the ventricle, and turn it to 

 the right until the resistance indicates that the mucosa is 

 securely engaged. Careful traction is now applied to the 

 handle, revolving the burr now and then a trifle, until the 

 everted mucosa from the bottom appears beyond the mouth 

 of the ventricle. Grasp the everted portion of the mucosa 

 securely with heavy curved, artery forceps and continue trac- 

 tion with these until the ventricular mucosa has been com- 

 pletely everted. Then cut away the everted mucosa by 

 excising it with the razor-shaped scalpel or by means of 

 long scissors at approximately the point indicated by the 

 dotted line in Fig. 22. 



While in many cases the muscles of the right arytenoid 

 cartilage appear but slightly, if at all, paralyzed, experience 

 teaches that it is usually best to operate upon both ventri- 

 cles at once. 



(The operation may also be performed without the use of 

 the ventricular burr, but it is more difBcult, especially upon 

 the standing animal. The technic is the same until the 

 removal of the ventricular mucosa is reached, when, instead 

 of the burr, the mucosa of the ventricle at its arytenoid 

 border is grasped with the forceps, tension is applied, and 

 the mucosa is incised along the arytenoid border and thence 

 along the summit of the vocal cord. The incision is con- 

 tinued at the point indicated by the dotted line in Fig. 22 

 until the ventricular mucosa has been isolated from that of 



