Some points in the symptomatology, pathology, and treatment of diseases of the sinuses adjacent and secondary to the orbit / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Some points in the symptomatology, pathology, and treatment of diseases of the sinuses adjacent and secondary to the orbit / by Charles Stedman Bull. 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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    method of examination as an aid to diagnosis is very uncertain. It is well known that the sinuses vary in size and shape in the same individual. One sinus may be completely wanting, or entirely rilled by a bony tumor. The dimensions of the frontal sinus are very variable, and they sometimes communicate with each other, or with the ethmoid, or with the orbit. All these facts contribute to the uncertainty of the results obtained by transillumination and to the possibility of a faulty diagnosis. Treatment: An abscess of the frontal sinus having been recognized, the indications are to open it as soon as possible, drain it carefully, inject bactericidal solu- tions, and put a stop to the suppurative process. _ In some rare cases of acute empyema, it may be possible to open the sinus internally by enlarging the infundi- bulum through the nose with a curette, and thoroughly irrigating the sinus by means of a catheter. But this is an extremely difficult procedure, as every one knows who has tried it, and never entirely satisfactory. Moreover, the opening of the ethmoid cells, which is often necessary in these cases, through the nasal mea- tus, is a difficult and dangerous undertaking. Hence it seems fair to state that the attempt to cure an empy- ema of the frontal sinus by enlarging the infundibu- lum in the nose, and by irrigation of the sinus from the nasal fossa through the fronto-nasal canal, is justi- fiable only in very recent cases and where the natural conformation of the nose admits of such interference. In all chronic cases, and in most of the acute cases, the frontal sinus should be opened externally by the Ogston-Luc method. The region of election is at the lowest part of the anterior wall of the sinus, imme- diately above the root of the nose. The external in- cision should be from an inch and a half to two inches in length, and should extend far enough tow- ard the opposite side to facilitate an opening into the other sinus, if such a procedure prove to be necessary.