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CHAPTER 16 | LYMPHATIC TECHNIQUES 495

HEAD AND NECK

Mandibular Drainage: Galbreath


Technique

Indications
This technique is indicated for any dysfunction or
lymphatic congestion in the ENT or submandibular
region, especially dysfunction in the eustachian tubes.
Care must be taken in patients with active temporo- FIGURE 16.10. Steps 1 to 3, setup and hand
mandibular joint (TMJ) dysfunction (e.g., painful click) placement.
with severe loss of mobility and/or locking.

Technique
1. The patient lies supine with the head turned slightly
toward the physician, and the physician sits at the
patient’s side, near the head of the table.
2. The physician stabilizes the patient’s head by plac-
ing the cephalad hand beneath the head to elevate it
slightly.
3. The physician places the caudad hand with the
third, fourth, and fifth fingertips along the pos-
terior ramus of the mandible and the hypoth-
enar eminence along the body of the mandible FIGURE 16.11. Step 5, caudad pressure on mandible.
(Fig. 16.10).
4. The patient opens the mouth slightly.
5. The physician’s caudad hand presses on the man-
dible so as to draw it slightly forward (arrows, Fig.
16.11) at the TMJ and gently toward the midline.
6. This procedure is applied and released in a slow
rhythmic fashion for 30 seconds to 2 minutes.
It may be repeated on the other side.

Nicholas_Chap16.indd 495 2/24/2011 3:12:22 PM