Successful removal of two osteomata of the orbit : one originating in the frontal, the other in the ethmoidal cells with a history of osteomata of the neighboring pneumatic cavities of the orbit / by Joseph A. Andrews.

Andrews, Joseph Andrew.

Date:: 1887

Credit: Successful removal of two osteomata of the orbit : one originating in the frontal, the other in the ethmoidal cells with a history of osteomata of the neighboring pneumatic cavities of the orbit / by Joseph A. Andrews. 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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$parts of the frontal bone were laid bare. The tumor was then exposed, it being in general spherical, with a few flat nodules, which filled the medial half of the orbit, and passing upward and inward to the orbital margin. At the summit of the tumor there was a mass of ivory- like bone, which was sharply defined from the red, spongy, softer surrounding bone, and showing that the tumor was a hard osteoma Ijicapsuled by a softer bony shell. Accordingly, this shell was removed piecemeal with the chisel. The shell was in close apposition to the tumor, but it was removed, because it was se[)arated from the tumor by a very thin layer of connective tissue. The frontal sinus contained considerable pus. The tumor was exposed on its medial border, and a strong iron elevator applied behind it, at the site of the spon- taneous perforation. By this means the tumor was forced out of its bed, exposing a prolongation of the tumor, which projected into the nasal fossa. The frontal sinus was found to be very much enlarged, and its lining membrane swelled and congested. In freeing the tumor a good deal of the enlarged frontal bone, i.e.^ superior orbital border, was chiselled away, so that under normal conditions the cranial cavity would have been freely laid bare. The wound was carefully disinfected, drained, and an antiseptic dressing applied. Healing without reaction. Ten days after operation the patient was dismissed, with wound closed. During this time the disturbance in circulation of retina disappeared. Movements of eyeball normal, but there was still dip- lopia. Tumor measured, from above downward, 5.8 ctm. ; in greatest diameter from right to left, 3.3 ctm. ; in greatest diameter from before backward, 3 ctm. ; weight, dried, 50 Gm. Case XXXII.—Kundrat {Wiener med. Blatter, 1883, No. xlviii.) observed an exostosis of the orbit which ex- tended very far into the cranial cavity, therefore it could not (?) be removed. The post-mortem examination showed that the tumor originated from the region of the$