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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    and extended upward to the frontal sinus. These cases are generally due to an attack of grippe _ Etiology: The etiology of suppuration of the frontal sinus is somewhat obscure. The predisposing causes are syphilis, tuberculosis, erysipelas, typhoid fever scarlatina, influenza, inflammatory lesions and polypi of the mucous membrane of the nasal fossa?, and wounds of the superior orbital margin. Both syphilis and tuberculosis may produce an osteo-periostitis of the frontal bone, followed by extensive caries and ne- crosis and profuse suppuration, and the frontal sinus may be invaded by the pus from without. In erysipe- las, the disease process extends through the mucous membrane of the nasal fossae to the infundibulum, and thence to the frontal sinus. But in order that suppu- ration should occur in a frontal sinus, there must be an entrance and proliferation of pyogenic microbes in the sinus. The latter may penetrate directly into the sinus through the nasal fossae, with or without infec- tion of these fossaa, either by way or* the infundibulum or by the lymphatics. The mucous membrane of the smus swells and becomes thicker, and thus the calibre of the infundibulum is narrowed and eventually obli- terated, and then the pus collects in the sinus and gives rise to the usual symptoms. When a mucocele becomes an abscess, there must have been present a second element of an infectious nature. Some assistance in diagnosis is occasionally gained by exploration of the sinus by transillumination with an incandescent lamp, the lamp being applied just beneath the orbital arch. The diagnostic value of this method is, however, nil, unless it prove positively the presence of pus in the sinus. If the latter exist, the area corresponding to the extent of the sinus, which should appear illuminated, is in shadow, owing to the presence of pus. Transillumination is of much less value as a means of exploration of the frontal sinus than it is for the maxillary antrum. This