470 



OPERATIONS ON THE BESPIEATOEY APPABATUS. 



tation with his fingers in the superior part of the trachea men 

 it is sufficiently expanded, a Ugature is applied upon the indaa 

 rubber tube, and this is cut off. Though the tampon is inflated, 



Fig. 412.— Arytenectomy. The secoiid step is OTer. The crioo-thyrold ligament, cri- 

 coid cartilage, crico-tracheal ligament and the two first tracheal rings are divided. 

 The canula and the tenaculum are in place— cc. Cricoid Cartilage, IR, First Blng of 

 the Trachea. 



the canula has a tendency to slip in the larynx, and for the pre- 

 vention of this accident should be secured by bands or strings tied 

 backward over the neck. 



Third Stage. — Ablation of the Arytenoid Cartilage. — The 

 ablation of the cartUage is effected by several steps : 



(a) Incision of the Mucous Membrane along the Superior 

 and Posterior Borders of the Cartilage. — With a blunt bistoury 

 and a sUght pressure, an incision is made in the mucous mem- 

 brane along the side of the superior and posterior borders of the 



