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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    outwards, and was blind. The patient insisted on an operation, though told that it would probably hasten the growth of the disease, as it could not be eradicated. The eye was enucleated, the contents of the orbit, densely infiltrated, were removed and all the infiltrated part of the lower lid cut away, and the place filled by sliding the cheek upwards. I did not see the patient for four months, and then the growth had filled the orbit, extended over upon the cheek as far as the middle of the superior max- illa and outwards into the zygomatic fossa. There were also some symptoms of a growth in the maxillary antrum. He was suffering great pain, and consented to removal of the growth from the orbit and from the external surface of the malar and maxillary bones, but declined to go any further. This operation showed that the tissues and skin of the face were involved as well as the bones. Subsequent to this operation the disease extended very rapidly upon the face and jaw, and involved, be- fore the patient's death, the temple and auricle. He died three months after the second operation, which was the fourth opera- tion in all. Case XXV. A gentleman, aged 50, first seen December 9, 1884. The right eye had been blind for nearly a year, and contained a large choroidal tumor, which had been suspected before from the general symptoms. There were no signs of perforation of the sclera, and the orbital tissue looked healthy, but, on opening the eyeball, the head of the nerve was found to be involved in the growth. The entire contents of the orbit were therefore removed, and as much of the optic nerve as pos- sible exsected. Orbit remained apparently healthy for fourteen weeks, and then a small gray nodule made its appearance at the apex. This was at once removed and the apex cauterized. In three weeks another nodule appeared on the nasal side of the previous one, and was removed on the third day after its appear- ance, and the bone again cauterized. At this time nothing was observed in any of the sinuses. For nearly two months nothing- abnormal was noted, and then three small nodules appeared, one at the apex, and two on the inner wall of the orbit, and grew with great rapidity. The patient's general condition was so bad that it was decided to postpone the operation. The