Traitement chirurgical ; un traité sur les pratiques de traitement des maladies chirurgicales pour l'usage des praticiens et des étudiants de chirurgie . qui est cousu à l'dischargingend du conduit ; la plaie est ensuite refermée sur tous (Fig. 1076). Il n'est pas nécessaire de rabattre les muqueuses dans un tube. Si la membrane de ofmucous est simplement aspiré à travers de l'embouchure de la parotide,et cousu à la glande de l'ouverture ou à la souche du conduit, un tube se forme.La perméabilité de la muqueuse canal peut être assuré en laissant une paire de ofstrands catgut chromique allongé sur la surface des muqueuses. La blessure à la

• Contributeur: The Reading Room / Alamy Banque D'Images
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Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . which is sewed to the dischargingend of the duct; the external wound is then closed over all (Fig. 1076). Itis not necessary to fold the mucous membrane into a tube. If the strip ofmucous membrane is simply drawn through from the mouth to the parotid, and sewed to the gland opening or to the stump of the duct, a tube will form.The patency of the mucous channel may be assured by leaving a pair ofstrands of chromic catgut lying on the mucous surface. The wound in themouth from which the strip was cut should be sewed. Cellulitis and abscess of the parotid are serious because of the danger ofsecondary intracranial infection. This may begin in the gland or in its em-braced lymphatics. The general and local treatment of cellulitis should beexpeditiously applied. Streptococcus infection and tubercular infectiondemand their specific treatment. As soon as an abscess forms, or sooner, the gland should be incised. Incisions should be placed so as not to injurethe facial nerve or the great vessels.. Fig. 1076.—Plastic Operation for Salivary Fistula of Cheek.The cheek has been opened by a short incision parallel with the filaments of the facialnerve. The fibers of the buccinator are separated and widely retracted, exposing the mucousmembrane of the mouth. A flap is cut from the mucous membrane, turned back and sewedas a funnel about the end of the duct. The mucous membrane wound is to be sewed, andthe muscles allowed to go back into place. Salivary Calculi.—Stones form usually in the duct of the submaxillarygland, although they may be found in any of the salivary ducts at their mouthsor in the substance of the glands. Appearing in the terminal ducts neartheir mouths, it is best to incise the duct at the stone and lift it out. Thewound heals without further attention. Stones developing in the substanceof the submaxillary gland are best treated by r

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