Blakesley Forceps

Blakesley forceps have the advantage of providing the surgeon with a delicate sense of how much pressure is being exerted between the ends of the forceps (Fig. 10.15 a, b).This is very important around the skull base to obtain a sense of the structures you are dealing with. These forceps are useful for getting hold of loose fragments of bone. However, they normally result in some degree of tearing of the mucosa.

Blakesley forceps are useful for punching a hole into the ethmoid bulla, then opening the forceps within it, and then pulling back with the jaws open. This will help open the hole further and expose the bulla's lining (Fig. 10.16). They should be used with care as their sharp end can easily puncture the lamina papyracea or skull base. They are strong enough to tear part of the middle turbinate off the skull base inadvertently. If they are used to remove bone or mucosa, it is best to use their sides. Even then, they run the risk of tearing mucosa and leaving denuded bone. The 90° forceps should be used with particular care; their use almost implies that their ends are to be placed out of view, so they should only be used where the operator can be certain that they are not going to cause any harm.

Denuted Bulla
Fig. 10.16 The straight and angled Blakesley forceps are useful in penetrating the ethmoid bulla.
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