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

  • Casey Albert Wood
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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    etc., packing with iodoform gauze, drainage-tubes of various kinds combined witb dilatation of the canal, and a number of other pro- cedures), with but temporary results. He had been a sufferer from nasal obstruction on the left side that had been greatly relieved two months before the swelling appeared by excision of an ecchon- drosis of the septum. He also reported that he had been a sufferer from frequent colds in the head, attended by considerable discharge from the nose. The examination of the nares and naso-pharynx shows very few changes on the right side, and the only noticeable abnormality on the left is a deviation of the septum that trenches upon the middle and superior meati. I was unable to pass a probe into the left frontal sinus. Owing to an obscure history of syphilis, the patient was put upon increasing doses of potassic iodide, and was given mercurial inunctions. In spite of all these remedial measures, including treatment of the nasal passages and attempts to open up the left infundibulum, the symptoms persisted, so that I advised an operation upon the frontal sinus itself. The patient was anaesthetized and a deep inci- sion, four centimetres in length, was made along the supra-orbital ridge, joining one at right angles to it (about three centimetres in length) in the median line, following the nasal crest. The triangular flap, including the skin and periosteum, between the extremities of the lines of incision was turned down, exposing the osseous struc- tures at the inner angle of the orbit, but avoiding as much as possible the pulley of the superior oblique. A button of bone was now re- moved by means of a medium-sized trephine and the sinus opened. After all bleeding had stopped, the exposed cavity was irrigated, giving vent to a quantity of muco-purulent secretion. On passing the little finger through the opening some granulation tissue was discovered, and removed with the curette; but as there was no ex- tensive disease of the mucous membrane lining the sinus, no attempt was made to drain that cavity through the infundibulum. It was packed with iodoform gauze and a few stitches placed at the extreme angles of the skin wound. This was renewed daily, while both the sinus and orbital pus-cavity were thoroughly irrigated with warm bichloride (1 in 3000) solution. The patient obtained almost immediate relief; the pains disap- peared, the purulent discharge subsided and became thin and
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