The more frequent diseases of the frontal sinuses : clinical lecture delivered at the post-graduate medical school, Chicago / by Casey A. Wood.

  • Wood, Casey A. (Casey Albert), 1856-1942.
Date:
[1900?]
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Licence: In copyright

Credit: The more frequent diseases of the frontal sinuses : clinical lecture delivered at the post-graduate medical school, Chicago / by Casey A. Wood. 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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    In thinking of the commoner diseases of the sinus one should bear in mind that they are mostly associated with diseases of the nose. They are often referred to as acute and chronic sinusitis and empyema. Acute inflammation of the frontal sinus is almost always due to the extension of an acute rhinitis to the mucosa lining the cavity. It is by no means a rare affection, and its symptoms are often at- tributed to the rhinitis, when they are really due to the deeper in- flammation. These are frontal and supra-orbital headache, increased on pressure at the supra-orbital notch, or at that part which usually corresponds to the situation of the sinus itself,—between the supra- orbital notch and the inner canthus. The headache is of a boring- character and is almost constant; it is increased by coughing, sneez- ing, lying down, and by indulgence in alcohol. It is often accom- panied by nausea and vomiting. Attempts to relieve this cold in the head by blowing the nose are mostly ineffectual. Scleral redness, lachrymation, and pain in the eyeballs are much more com- mon than when the patient has a simple coryza only. The diagnosis is made with certainty if a discharge from the nose is followed by sudden relief of the pain. The symptoms may entirely cease and total recovery ensue, or the disease may pass into the chronic form. In my experience the latter termination is rare when the nasal dis- ease disappears. In other words, we rarely have a chronic inflam- mation of the frontal sinuses when there is no corresponding chronic nasal disease. Chronic diseases of the mucous membrane lining the frontal sinuses are mucocele and empyema, and their commonest causes are infection from some form of rhinitis, or disease of the ethmoid cells, —often the syphilitic variety,— combined with a partial or complete closure of the infundibulum. Collections of mucus or muco-pus, pent up within the sinuses, are unable to escape through the drain- age-canal of the infundibulum, so that infection and pressure symp- toms follow. There is much less pain in the chronic forms of the disease, but swelling of the parts is more marked. The infun- dibular obstruction is commonly due to caries of the bones of the nose, polypi, hypertrophic rhinitis, and outgrowths from the septum. If for any reason the obstruction be momentarily removed, the pus or mucus is discharged and much relief is obtained. With returning obstruction of the infundibulum comes recurrence of the pain, swell-