A case of extensive chronic empyema of the frontal and ethmoidal sinuses with exophthalmos : operation; recovery / by Arnold H. Knapp.

  • Knapp, Arnold Herman, 1869-1956.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: A case of extensive chronic empyema of the frontal and ethmoidal sinuses with exophthalmos : operation; recovery / by Arnold H. Knapp. 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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    A CASE OF EXTENSIVE CHRONIC EMPYEMA OF THE FRONTAL AND ETHMOIDAL SINUSES WITH EXOPHTHALMOS; OPERATION; RE- COVERY. By ARNOLD H. KNAPP, M.D. ( IVtt/i a figure on Text-Plate I.) S. R., thirty-five years of age, came to the Dispensary of the New York Ophthalmic and Aural Institute on February 25, 1898, complaining of protrusion of his left eye and a discharge from the nose, of one year's duration. On examination, an exophthalmos was very noticeable ; the eye not only protruded, but was displaced down and out. The upper lid was thickened and drooped, covering a soft swelling in the upper part of the orbit. Pressure on this swelling caused thick pus to appear in the left nasal passage. The mobility of the eye was restricted, the vision normal. Ophthalmoscopic examination revealed venous congestion of the retina. On examining the nose, the left middle turbinate was found hypertrophied and pressed against the septum. The middle meatus contained poly- poid masses and thick offensive pus. The probe detected ex- tensive necrosis of the ethmoidal cells. Exploratory puncture of the left maxillary antrum proved negative. The patient other- wise appeared to be in excellent health ; there was no evidence of an intracranial complication, nor of any constitutional disease. A futile attempt was made to improve the nasal condition by removing the hypertrophic masses in the middle meatus and curetting the ethmoidal cells, but the disease was found to be too extensive, and the external operation was immediately decided upon. On March 5th, under ether-anaesthesia, the left nasal passage was plugged posteriorly to prevent the entrance of pus or blood Reprinted from the Archives ok Ophthalmology, Vol. xxviii., No. i, 1899.