deformity known as _frog-face_. Deafness
may result from obstruction of the Eustachian tube. The patient
suffers from intense frontal headache, and there is a persistent and
offensive mucous discharge from the nose. Profuse recurrent bleeding
from the nose is a common symptom, and the patient becomes profoundly
anaemic. The tumour can usually be seen on examination with the nasal
speculum or by posterior rhinoscopy, and its size and limits may be
recognised by digital examination.

Unless removed by operation these tumours prove fatal from haemorrhage,
interference with respiration, or by perforating the base of the skull
and giving rise to intra-cranial complications.

_Treatment._--These growths are seldom recognised before they have
attained considerable dimensions, and owing to the fact that they are
permeated by numerous large, thin-walled venous sinuses, their removal
is attended with formidable haemorrhage. Attempts to remove them by the
galvanic snare are seldom satisfactory, because the base of the tumour
is left behind and recurrence is liable to take place. The operative
treatment is described in _Operative Surgery_, p. 153.

CHAPTER XXVI

THE NECK

Surgical Anatomy--Malformations: _Cervical auricles_; _Thyreo-glossal
cysts and fistulae_; _Lateral fistula_--Cervical ribs--Wry-neck:
_Varieties_; _Cicatricial contraction_--Injuries:
_Contusions_--_Fractures of hyoid, larynx, etc._:
_Cut-throat_--Infective conditions: _Diffuse cellulitis_;
_Actinomycosis_; _Boils and Carbuncles_--Tumours: _Cystic_:
_Branchial cysts_; _Cystic lymphangioma_; _Blood cysts_; _Bursal
cysts_--_Solid_: _Lipoma_; _Fibroma_; _Osteoma_; _Sarcoma_;
_Carcinoma_--The thymus gland--The carotid gland.

#Surgical Anatomy.#--In the middle line the following structures may
be recognised on palpation: (1) the _hyoid bone_, lying below and
behind the body of the lower jaw, on a level with the fourth cervical
vertebra; (2) the _hyo-thyreoid membrane_, behind which lies the base
of the epiglottis and the upper opening of the larynx; (3) the
_thyreoid cartilage_, to the angle of which the vocal cords are
attached about its middle; (4) the _crico-thyreoid_ membrane, across
which run transversely the crico-thyreoid branches of the superior
thyreoid arteries; (5) the _cricoid cartilage_, one of the most
important landmarks in the neck. It lies opposite the disc between the
fifth and sixth cervical vertebrae