Orbitalphlegmone und Sehnervenatrophie / von J. Öller.

  • Öller, J.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Orbitalphlegmone und Sehnervenatrophie / von J. Öller. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    the illumination of the cavitj hj means of Hering's electric-lamp will greatlj assist in Clearing up any doubt. As a matter of ex- perience, abscess of tlie frontal sinus has been mistaken for lacb- rymal abscess and erysipelas. The fact tliat the tumor maj present beneath the orbital margin above the eyeball renders it possible for mistakes in diagnosis to be made. It ma/be said that, in addition to these signs and Symptoms, pus foimd for some time in the middle meatns means either disease of the frontal, the maxillary, or sphenoidal sinus. If the flow of pus be intermittent and fetid, it is probablj an affection of one of the last two. When protrusion of the eyeball occurs, it is almost always forward and outward in ethmoidal disease, and forward and down- ward in frontal sinus disease; while in disease of the sphenoidal cavity it 'is directly f orw^ard and slightly outward. The treatment of the acute form includes that of the acute nasal disease that gave rise to it. The frequent use of cocaine, which relieves pain and opens up the passage into the sinus, is one of the best remedies we possess. It is a good plan to thoroughly cocainize the Upper portion of the nasal meati, and then direct the patient to blow his nose vigorously on the affected side. This procedure en- courages the passage of mucus f rom the diseased sinus. Disinf ectant lotions are also of value, especially a mild alkaHne spray with lis- terine. Hot fomentations may be applied to the forehead and face. I have lately used with good effect the so-called lavoline atomizer, with or without an oily Solution of menthol, directing the point towai-ds the infundibulum. This helps to clear out the passage and to encourage the downward flow of secretions. As soon ES the acute Symptoms have passed off, additional meas- ures should be taken to insure a clear passage from the sinus to the nasal meatus. Polypi should be removed, caries treated,—internal remedies are of great value when syphiHs is present,—and the nasal passages brought as quickly as possible into the normal condition. In the chronic forms of the disease probes and catheters have been recommended, but these are not always successful. My investi- gations of the infundibulum have shown me that it is an extremely difficult matter to pass a probe succcssfully, at least in the majority of mstances. Not only does the canal vary in size, shape, and direc- tion, but abnormal obstructions to the passage of the instniraent are nearly always present in just those instances where-it is desirable to pass it.