SECTION II 



SURGERY OF THE HEAD AND NECK 

 Hematoma of the Ear Flap 



HEMATOMA consists of an effusion of blood 

 or serum between the skin and cartilage. It 

 is due to trauma, and first appears as a painful 

 fluctuating swelling on either the under or upper 

 surface of the ear flap, or in some cases on both 

 surfaces. If not dealt with the contents of the sac 

 become organized and by contraction produce a most 

 unsightly distortion of the ear. 



Materials for operation. — The following instru- 

 ments, sutures, and dressings are sterilized and 

 placed in sterile trays ready for use : One scalpel, 

 two pairs of artery forceps, one needle forceps, ten 

 straight needles, ten silkworm-gut sutures, one 

 curette, one dressing forceps, cotton-wool swabs, 

 aseptic gauze, dressing (iodized collodion), aseptic 

 wool (ether), one ear cap or many-tailed bandage, 

 a piece of rubber sheeting ten by twelve inches in 

 size with a slit three inches long in the middle. 



Place the patient in the abdominal position and 

 induce general anesthesia. 



Technic. — Both sides of the ear flap are shaived 

 and prepared as before described. The external 

 auditory meatus is plugged with cotton wool and 

 the ear pulled through the slit ^n the rubber sheet, 

 which is laid over the patient's head and neck in 

 order to prevent the operative area touching it. 



A longitudinal incision is made in the center of 

 the swelling, sufficiently large to permit of the 

 complete evacuation of the contents, which may 



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