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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    pressure in the orbit. Nothing was found after most careful examination, but the pain increased, he complained of general headache and fullness in the head, and of a dimness of vision in the other eye. Ophthalmoscopic examination showed begin- ning choked disc, which pointed to an extension backwards towards the chiasm, an unusual course for such cases to take. Two weeks later the growth could be seen in the optic foramen and sphenoidal fissure, and the head symptoms became more pronounced. He sank rapidly and died comatose, about four- teen weeks after the operation. No autopsy was allowed. Case XXXII. A gentleman, aged 46, first seen November it, 1887. Nine months before, began to have pain in left orbit and left side of head, and soon after had a profuse purulent discharge from left nostril and pain was relieved. Long sub- ject to naso-pharyngeal catarrh, and this was supposed to be an abcess in the ethmoid which had discharged. In August the pain returned in the orbit and the eye became red and painful. Early in October the left eye began to protrude and diplopia ensued. A growth could be felt on the inner wall and floor of the left orbit, and the superior nasal meatus was blocked by the same growth. Vision in the left eye was only 20/200, and there was optic neuritis with numerous hemorrhages. I gave a very unfavorable prognosis and was unwilling to operate, but he begged for relief from the pain, and I consented. The eye was enucleated and the contents of the orbit were removed. The os planum was absent and the ethmoid cells were filled with the growth. This was removed, a large opening was made into the superior nasal meatus, the nose was entirely emptied of the growth, and a careful examination was then made of the orbit. The tumor was seen projecting from the sphenoidal fissure, and probably originated in the sphenoidal sinus. The maxillary sinus was apparently not involved. Drainage was kept up through the nose for two weeks. In five weeks the growth appeared in the ethmoid cavity and apex of the orbit, and was again removed. This patient submitted to five operations. At the third operation, the ethmoid, supe- rior maxilla, palate, and part of the sphenoid were removed, and only seemed to facilitate the return of the tumor. He died four