Abstract
I have used a trephine with considerable satisfaction during the past two years in making a preturbinal opening in the maxillary sinus. Two sizes are made by V. Mueller & Company, Chicago, one 7 mm. and the other 9 mm. in size. The accompanying sketch will give an idea of its construction. Apart from the basic essential of a hollow trephine driven by palmar pressure and rotation, the important feature is a sliding metallic sleeve with two deep notches at opposite points on the periphery, which may be applied over the sharp edge of the denuded crista pyriformis just anterior to the lower turbinate. The sleeve is provided with a handle to be held in either the right or the left hand, depending on which antrum is to be opened. The patient's head is supported firmly against a head rest and turned slightly toward the side on which the operation
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