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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    etc., pacldng with iodoform gauze, drainage-tubes of various kinds combined with dilatation of the canal, and a nmnber of other pro- cedures), with but temporary results. He bad been a sufferer from nasal obstruction on tbe left side that bad been greatlj relieved two months before tbe swelling appeared bj excision of an eccbon- drosis of tbe septum. He also reported tbat be bad been a sufferer from frequent colds in tbe bead, attended hj considerable discbarge from tbe nose. Tbe examination of tbe nares and naso-pbarynx sbows very few cbanges on tbe rigbt side, and tbe only noticeable abnormality on tbe left is a deviation of tbe septum tbat trencbes upon tbe middle and superior meati. I was unable to pass a probe into tbe left frontal sinus. Owing to an obscure bistory of sypbilis, tbe patient was put upon increasing doses of potassic iodide, and was given mercurial inunctions. In spite of all tbese remedial measures, including treatment of tbe nasal passages and attempts to open up tbe left infimdibulum, tbe Symptoms persisted, so tbat I advised an Operation upon tbe frontal sinus itself, Tbe patient was anasstbetized and a deep inci- siön, four centimetres in lengtb, was made along tbe supra-orbital ridge, joining one at rigbt angies to it (about tbree centimetres in lengtb) in tbe median line, f ollowing tbe nasal crest. Tbe triangulär Aap, including tbe skin and periosteum, between tbe extremities of tbe lines of incision was tumed down, exposing tbe osseous struc- tures at tbe inner angle of tbe orbit, but avoiding as mucb as possible tbe puUey of tbe superior oblique. A button of bone was now re- moved by means of a medium-sized trepbine and tbe sinus opened. After all bleeding bad stopped, tbe exposed cavity was irrigated, giving vent to a quantity of muco-purulent secretion. On passing tbe little finger tbrougb tbe opening some granulation tissue was discovered, and removed with tbe curette; but as tbere was no ex- tensive disease of tbe mucous membrane lining tbe sinus, no attempt was made to drain tbat cavity tbrougb tbe infundibulum. It was packed witb iodoform gauze and a few stitcbes placed at tbe extreme angies of the skin wound. Tbis was renewed daily, wbile botb tbe sinus and orbital pus-cavity were tborougbly irrigated witb warm bichloride (1 in 3000) Solution. The patient obtained almost immediate relief; tbe pains disap- peared, tbe purulent discbarge subsided and became tbin and