West Virginia argus. [volume] (Kingwood, W. Va.) 1877-1946, 1889-12-26
NOSES MADE TO ORDER.
a NOVELTY IN THE PROGRESS OF
MODERN SURGERY.
n FLAP of Periosteum From the Fore
head Developed Into n Nose Bridge
Curious Skin Grating.

~ q
head Developed Into Nose Bridge
Curious Skin Grating.
A novel and interesting case Of wha
may be called nose building has set people
who keep the run Of surgical work in
mind n talking. Mrs. Hoffman, who
lives in Brooklyn. had suffered from nasal
catarrh until she had no nose left. Bones
as we'll as tissues were gone. In this condi-
ton she applied to DIR. +. l.. II. Tetamore,
of New York city, who had had a good
many cases Of skin grating and facial re.
pairing generally, to see whether he could
build a nose.
The doctor, after an examination of the
case, had her placed under the influence
OF an an9sthetic. Then he cut AWAY the
skin that covered the nasal cavity. Next
the flesh on the forehead, Immediately
above the nose, was dissected back in
maps, so as TO lay bare a w~edge-shaped
portion of the skull there. The bone is
covered with a skin, as nearly every one
knows, and a flap of this bone skin
(periosteum) of the shape of a truncated
V was dissected from the bone, save only
that the point of the V was left attached
to the skull between the eyes. This flap
was twisted SO that when il was laid
down over the nasal cavity the side that
had been next to the bone was down.
Meantime a live chicken had been cut
open, and a bit of its breast bone of the
right size and shape to form a nose was
cut out and stitched fast over the nasal
cavity. This bone formed n bridge which
supported the flap of periosteum up in
the shape OF a nose. The periosteum
was therefore stitched over this bridge.
Then, when that was done, the skin and
tissues from the cheeks of the patient
were drawn up over the new nose and
stitched there, forming the fleshy part of
the nose.
or course, every care was taken in the
use OF antiseptics. At the end of ten
days the chicken bone came away.
Meantime the periosteum had developed
into a thin shell of bone perfectly able
to support itself, and a membrane had
grown over what had now become the
nostrils of the new nose. OF course.
provision had been made for the growth
of a central cartilage as well as an outer
frame work. At the end Of twelve DAVIS
the outer wounds had healed. including
the wound on the forehead, from which
the periosteum had been removed.
The interior of the nose was longer in
healing, but is now well, and Mrs. Hoff-
man once more has a nose that she is
proud of.
"When l adopted the chicken bone"
said DIR. Tetamore to writer of the New
York San, 81 did 1t because it was of
about the right form and because I
wanted to see whether it would really
grow into the place and serve the pur-
pose. 1t was not n new idea, for the
flesh of animals has hitherto been grated
lnto that of human beings. But / was
perfectly sure that the periosteum would
develop a thin plate of bone, and that
was all that was needed. The chicken
bone served meantime as n support"
DR.. TetamoTe has a more difficult case
on hand than that of Mrs. Hoffman. 1t
is that of a woman who has lost her nose
and is so terribly deformed that there is
not enough flesh and tissue on the sides
of the nasal cavity to draw up over IL
when a new nose shall be made for IL
from the periosteum from the forehead.
In dealing with this case DIR. Tetamore
has discarded the chicken bone entirely.
and Tor the support of the nose has sub
stftuted a framework made of thin Stats
Of ivory.
To begin with he made a plaster cast
OF the woman's face. Then he took soft
rubber and constructed a nose of the
proper form to fit that face. This rubber
nose gave the size and shape of frame
work necessary to support the new nose
and the size Of the flap to be cut from
the forehead. Having made the ivory
frame in his Office, he had the woman
placed on the dissecting table and dis
sected away the flesh from around the
nasal cavity and laid bare the bone all
around. Then he fastened the ivory
frame over the nasal cavity by lacking
the ends of the ivory Stats fast to the ex-
posed bone with ivory tree nails. This
done, a flap not only of periosteum from
the skull above the eyes, but its covering
of flesh and skin were lifted up, twisted
around and laid down over the ivorv
frame work, provision being made for
the middle cartilage as before. This
flap was sowed down TO the flesh of tho
face and the lip. The wide wound on
the forehead will doubtless fill up. as
clean-cut wounds always do. The fan
over the ivory frame will grow around
over It, and it will always remain there.
HNNN - NV HNehb N'ptCNs
"How did you happen to make n
speciality Of removing facial blemishes
and building mp where such deformities
existi' was asked.
ut was a number Of years ago. when
an unfortunate young woman, who had
lost her nose and part of her upper lin.
came TO me TO sec if / could do ANYTHING
for her. / had been a dentist when a
younger man, and so concluded to try
making a soft rubber nose and lin. /
succeeded so well that she was afterward
able TO get married. That set me TO
thinking about like cases, and 7 took up
the study. ! suppose that the building
OF q nose is the most important piece Of
work Of the kind, although the covering
OF such scars as arc made by burns where
the face is drawn out Of shape are also
well worth attention. It is only within
a few years that such things have been
possible, but now surgeons can do pretty
extensive jobs in repairing crippIos. So