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)

    15/34 (page 13)
    from cataract, and, as the disease had- involved the orbit, I ad- vised an immediate enucleation and removal of the contents of the orbit. This was immediately done, and the whole orbital tissue found diseased. The optic nerve looked healthy, but a piece was excised. The case was watched very carefully, but nothing suspicious was noticed for nearly three months, when a hard nodule was discovered at the apex of orbit. This grew very slowly for nearly two months, when it suddenly grew softer and then spread with extreme rapidity. The patient then consented to a second operation, which was made as radical as the nature of the case would admit. Three weeks from the second opera- tion the growth again appeared at the apex of the orbit, increased very rapidly, the patient's condition became alarming, and he died suddenly five weeks after the second operation. Case XI. ( A lady, aged 26, first seen July 7, 1879. There had been failure of vision in the left eye for more than two years and the eye had been blind for about five months, prob- ably from tumor of the choroid and detachment of the retina. It was now very painful from iridochoroiditis, and I advised its removal. Enucleation revealed the fact that the optic nerve was involved in the disease and that the sclera had been per- forated close to the entrance of the optic nerve. The entire contents of the orbit were removed, the optic nerve pulled for- ward, and as large a piece as possible was exsected, and the periosteum was stripped from the bones all round as far as the apex and removed. For about three months there was no return of the growth, but early in October it made its appear- ance at the apex, and by the end of the month the growth had entirely filled the orbit and protruded between the lids. The orbit was again cleaned out, but all the sinuses were found to be involved. The os planum of the ethmoid was removed, and the floor of the orbit also, and the contents of the ethmoid, sphenoid, and maxillary sinuses cleaned out. By December a small nodule appeared in the upper lid near its center and was immediately removed. The growth did not return until March 8tk, when a large nodule was found at the inner end of the upper lid which extended into the nose and also into the lower lid, and another mass was found at the apex of the orbit.