Some points in the symptomatology, pathology, and treatment of diseases of the sinuses adjacent and secondary to the orbit / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Some points in the symptomatology, pathology, and treatment of diseases of the sinuses adjacent and secondary to the orbit / by Charles Stedman Bull. 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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    self in a totally different part of the area of influence of the trifacial nerve, and thus lead to a faulty diag- nosis. Attempts have been made to treat the interior of the sphenoid antrum through the nose, but the posi- tion of the opening into the nose is so variable, and the use of the rhinoscopic mirror is so unsatisfactory, that such attempts have usually been abandoned. Trans- illumination is of no practical value here in assisting us in a diagnosis. Inasmuch as the ethmoid cells are usually involved in abscess of the sphenoid antrum, if entrance through the nose proves futile it is better to open the ethmoid through the orbit, clean out the con- tents, and then penetrate the sphenoid antrum and thoroughly curette its interior. Tumors of the Sphenoid.—So long as a new growth is limited to the sphenoid antrum, either the subjective symptoms are entirely absent, or there may be severe pain in the head, usually in the occipital region. If the process extends to the adjacent struc- tures, symptoms arise which point to the probability that the sphenoid bone is the seat of the disease, such as blindness due to compression of one or both optic nerves, and the visible or tangible presence of the growth in the nose, ethmoid, orbit, or skull. The en- trance of the growth into the cranial' cavity may occur without any subjective symptoms, or there may be sudden, severe headache. If the progress of the growth is very rapid, meningitis or cerebral abscess will re- sult. The ophthalmoscopic symptoms are either papil- litis or atrophy of the optic nerve due to perineuritis and pressure of the swollen nerve-sheath on the optic nerve fibres. In some cases the pressure is exerted on the nerve in the optic canal. Tumors here may perforate the middle fossa of the skull without caus- ing blindness. If an orbital tumor rapidly causes blindness, and the latter starts from the temporal side of the field and leaves the region of the macula lutea unaffected to the last, and if at the same time a growth