The course and prognosis of orbital tumors as influenced by surgical operations for their removal / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1896]
Catalogue details

Licence: Public Domain Mark

Credit: The course and prognosis of orbital tumors as influenced by surgical operations for their removal / 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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    perforated the sclera posteriorly close to the entrance of the optic nerve, and had extended into the orbit. The optic nerve looked healthy. The contents of the orbit were removed down to the periosteum, and the optic nerve was drawn forward and a considerable piece exsected. Nothing abnormal was noted in the orbit for nearly two months, and then a suspicious infiltration ap- peared in the vicinity of the optic foramen. This was immediately cauterized, but in spite of this grew rapidly, and within five weeks had completely filled the orbit. The child's general condition was bad, but a second exenteration of the orbit was done, and the entire periosteum was removed. This second operation was followed in less than a month by the reappearance of growth in the sphenoidal fissure. The child's general condition was so bad that no further operative interference was justifiable, but the location of the second return of the growth showed that the deep cavities of the bones at the base of the skull were involved. The tendency of this growth was forward and outwards, and, though the child lived for five months longer, there were no head symptoms until three days before his death, which occurred in profound coma. Case IV. A lady, aged 35, first seen June 15, 1874. Vis- ion began to fail in the left eye three years before, and this eye had been entirely blind for three weeks. There was a yellow- ish reflection from the pupil, which was seen to be a highly vascularized new growth. Enucleation was advised, and was done two days later. At the operation it was found that the tumor had perforated the sclera at one point in the post-equato- rial supero-nasal quadrant, and entered the orbit. Radical ex- enteration of the orbit was immediately performed, but the peri- osteum seemed healthy and was not disturbed. For four months nothing abnormal was observed, and then the growth appeared on the floor of the orbit far back. At the second operation the periosteum was stripped from the orbit, and the bony surface carefully cauterized. This was followed by slight suppuration, which soon ceased. Three months later the growth appeared at the junction of the inner wall and floor of the orbit, and was immediately removed and the bone again cauterized. Almost