Orbitalphlegmone und Sehnervenatrophie / von J. Öller.

  • Öller, J.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Orbitalphlegmone und Sehnervenatrophie / von J. Öller. 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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    ing, and otlier signs of the disease. This State of affairs may exist for montlis, and even years, during which time tlie secretions may find vent throiigh some abnormal cliannel. When the Symptoms are intermittent in tliis way, one should always suspect at least mucocele of the frontal sinus. Complete closure of the natural opening soon results in dilatation of the sinus or of both sinuses, and pressure upon the surrounding parts makes this piain. At the inner angle of the orbit a soft, sometimes crepitating, and often plainly visible tumor shows itself. Empyema of the sinus is rare before forty years of age. TJnlike nasal-duct obstruction and lachrymal abscess (some of the signs of which it simulates), it is commoner in men than in women, probably because the cavities are better developed in the former. The same causes that serve to produce mucocele operate to bring about pus- formation in the sinuses. In addition to the causes already given for the milder disease, syphilis and traumatism might be mentioned. The Symptoms of abscess of the frontal sinus much resemble those of chronic mucous Sinusitis. Instead of an outpouring of simple mucus from the nose on the affected side, with a correspond- ing relief of the Symptoms, we have an irregulär, fetid, purulent discharge. It is well to remember that as the pus drips down or flows from the superior cavity it not infrequently infects the maxil- lary sinus beneath it, and it often happens that empyema of the frontal sinus is associated with the same process in the antrum of Highmore. In addition to the Symptoms of mucocele just detailed, there may be rise of temperature, chills, excruciating pains, and even brain Symptoms, from pressure. The tumor presents at the inner angle, at a level with the bridge of the nose, while the palpebral and other skin in that neighborhood finally becomes red, swollen, and tender to the touch. There is often exophthalmus accompanied by diplopia. When the abscess breaks (being unable to discharge through the infundibulum), it usually ruptures externally; but there are cases on record where it has opened into the cranial cavity with fatal re- sults. Sometimes the amount of fluid found in the sinuses is very large, and this is much more likely to be the case where the disease has lasted a long time, and where there have been intermittent openings of the infundibular passage. The diagnosis is not always easy. The use of the skiagraph and