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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    forwards, but no limitation of motility. Vision had begun to fail two weeks before and was reduced to 20/100. A growth could be felt on the inner wall of the orbit, far back. This patient had suffered severely from constitutional syphilis. The eye was enucleated and entire contents of orbit were removed. The tumor was not encapsulated. Periosteum appeared smooth and healthy. Return of the growth on the inner wall of the orbit far back within three months. This was removed five months after the first operation, and it had then involved the floor and inner wall of the orbit, the apex and sphenoidal fissure, and there was erosion of the os planum of the ethmoid. The periosteum was then stripped up and removed and the bones cauterized. This operation seemed to hasten the return of the tumor in the orbit, as it grew with great rapidity from the sphenoidal sinus. One month after the second operation the growth was again removed from the orbit and the ethmoid was then found to be involved. Two more operations were done at intervals of two montns, the growth being on each occasion removed from the orbit and ethmoid cavity. After the fifth operation the patient declined to have anything further done, but lived for more than a year before he succumbed to general exhaustion. Case XXII. A lady, aged 46, first seen February 8, 1884. Right eye began to protrude about two years ago and vision has gradually failed. The exophthalmos is forwards, inwards, and downwards. Constant pain in orbit and head. Media clear, V = o. Tumor can be felt on external wall and floor of orbit. Eyeball immovable outwards and downwards. The eye was enucleated and the entire contents of the orbit removed. Orbital tissue generally infiltrated by the growth, which also extended backwards through the optic foramen, and into the sphenoidal fissure. Ethmoid apparently uninvolved.. Return of the growth from both sphenoidal fissure and optic foramen within five weeks after the operation, and as much as could be reached at once removed. Headaches became more severe, and the growth soon appeared in the upper nose. Orbit remained free for two months and then began to fill rapidly again from the apex. This was again removed, and a large mass was also