Chirurgie opératoire, pour étudiants et praticiens . Fig. 75.—Résection De La Mâchoire Supérieure. L, incision de Langenbeck; V, incision de Velpeausincy; W, incision de Weber. La bordure inférieure du lobe de l'oreille, et est ensuite portée à un point sur la proéminence de l'os de joue. Cette incisionne divise pas la lèvre, mais il sera nécessaire plus tard de séparer la lèvre de son attachement à l'os de la mâchoire. Il divise certains branchesdu nerf facial, ce qui est un inconvénient. La surface avant de l'os est exposée en réfléchissant le volet vers le haut, sous-périostéale, si L'ON AGIT SUR LE VISAGE. 145 les conditions perm

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Operative surgery, for students and practitioners . Fig. 75.—Resection of Upper Jaw. L, Langenbeck incision; V, Velpeauincision; W, Weber incision. the lower border of the lobe of the ear, and is then carried upwardto a point over the prominence of the cheek-bone. This incisiondoes not divide the lip, but it will be necessary later to separatethe lip from its attachment to the jaw-bone. It divides some branchesof the facial nerve, which is a disadvantage. The front surface ofthe bone is exposed by reflecting the flap upward, subperiosteally, if OPERATIONS UPON THE FACE. 145 the conditions permit. In raisino- the flap from the bone the infra-orbital vessels and nerve are divided. In making either of these incisions the facial artery is dividedand must be clamped and ligated. After the soft parts have been detached from the bone the carti-lage of the nose is separated from the nasal notch, and the soft parts.. Fig. 76.—Resection of Upper Jaw. When it is desired to leave the majorpart of the malar bone, the line of section through the bone should be asIndicated upon the right side of the skull. If the malar bone is to be removedtogether with the superior maxillary, the section through the bone should be asis represented upon the left side of the skull, the line of division passing throughthe frontal process of the malar and the zygoma. corresponding to the lower margin of the orbit, raised from the bone, and the tarso-orbital fascia cut along the margin of the orbit. Thefloor of the orbit being thus exposed, the contents of the orbit areraised out of the way with a blunt retractor. We are then ready tocut through the nasal process of the superior maxillary. This di-vision extends from the margin of the nasal notch, across the nasalprocess, as far as the lacrymal groove or fossa. It is necessary to 10 146 HEAD AND FACE. avoid injury to the lacrymal sac^ the upper expanded part of thelacrjona

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