The  operation  for  the  complete  removal  of  the  maxillary  bone  is
indicated  where  the  fibrinous  growth  has  become  very  extensive
and  involves  the  nasal  bone  and  sinuses  of  one  or  both  sides  of  the
head.
The  question  of  preliminary  laryngotomy  is  one  that  must  be
left  to  the  operator,  especially  in  the  removal  of  the  superior  maxillary
bone.
Where  the  operation  is  performed  through  the  mouth,  preliminary
laryngotomy  is  indicated.
In  the  Lawrence  and  Oilier  operation,  the  question  of  preliminary
laryngotomy  is  necessarily  dependent  upon  the  size  of  the  growth
to  be  removed.  If  the  growth  does  not  extend  into  the  nasal  pharynx
plugging  the  post-nasal  space  may  be  performed.
DISEASES   OF    THE    NOSE.  379

The  same  rules  of  operative  procedure  for  the  removal  of  fibro-
mata may  apply  to  the  removal  of  malignant  neoplasms.
Chondromata  or  Enchondromata. — Chondromata  or  enchon-
dromata  are  tumors  made  up  of  hyaline  cartilage,  nbro-cartilage
or  a  combination  of  the  two.  Their  origin  is  more  often  on  the
septum  of  the  nose.  Tumors  of  this  character  possess  an  adherent
capsule.
Diagnosis. — The  size  of  the  chondromata  varies  and  may  be  small
or  of  large  dimensions,  sometimes  undergoing  cystic  degeneration.
In  the  early  stages  of  the  growth  of  the  tumors  they  are  hard  and
immovable.
Chondromata  may  occur  at  any  age  and  sometimes  change  into
sarcomata.  Unless  the  growth  is  entirely  removed,  recurrence  takes
place.  If  the  growth  cannot  be  removed  through  the  nose,  the
Lawrence  or  Oilier  operation  is  indicated.
Treatment. — Complete  removal  of  the  growth  and  its  capsule  by
excision  is  early  indicated  on  account  of  the  tendency  to  change
into  sarcoma.
