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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    the eyeball remains intact or is involved secondarily and late in the course of the disease, the same unfavorable prognosis, as to return and rapidity of growth, must be made. Even when the orbital tumor appears to be encapsulated, experience proves that there is no certainty that some germs have not been left behind. Moreover, malignant growths in the orbit are very rarely encapsulated. 3d. Extra-orbital tumors, originating in the bones or sin- icses adjacent to the orbit, and involving the orbit secondarily. This third class of cases embraces the most serious and des- perate of all. The cavities and bones usually involved are the sphenoid and ethnoid. The nature and origin of these growths may often be diagnosticated in the beginning, as soon as orbital symptoms arise, and sometimes even before any such symptoms present themselves. The prognosis in these cases must be put down as absolutely bad from the beginning. No matter where the origin of the growth, all the deep bones of the face and their communicating sinuses eventually become involved. By emptying the sinuses and extensive exsection of the bones diseased, we do not succeed in arresting the progress of the malady, and experience has taught the writer that every opera- tion in these cases tends to increase the certainty of return and the rapidity of its growth, and in so far shortens the life of the patient. Each operation, being of necessity the more extensive and severe, saps the strength of the patient and weakens his powers of resistance. The tendency of these malignant tumors of the orbit, whether primary or secondary, is to grow forwards or outwards, rather than inwards or backwards, and this fact probably ex- plains why patients afflicted with such tumors live as long as they do, and why they usually die from general exhaustion, rather than from extension of the growth to the brain. It is the exception when these tumors cause death by extension to the brain, whether through the roof of the orbit, or through the optic foramen, or through the sinuses at the apex of the orbit. The tendency to extension outwards and forwards of these tumors may perhaps also explain the increased rapidity of their