The surgical treatment of orbital complications in disease of the nasal accessory sinuses / by Arnold Knapp.

  • Knapp, Arnold Herman, 1869-1956.
Date:
[1908]
Catalogue details

Licence: In copyright

Credit: The surgical treatment of orbital complications in disease of the nasal accessory sinuses / by Arnold Knapp. 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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    COMPLICATIONS IN DISEASE OF THE NASAL ACCESSOEY SINUSES.* ARNOLD KNAPP, M.D. NEW YORK. The orbital complication referred to in this paper is the subperiosteal abscess. When disease of the nasal accessory sinuses extends to the orbit, the infection passes through the os planum of the ethmoid or through the floor of the frontal sinus. Two clinical pictures will be present, depending on whether the perforation occurs suddenly or gradually—acute or chronic. In the former, the local symptoms are those of an acute ab- scess with cellulitis. The orbital manifestation may disappear with intranasal treatment or the pus works its way to the surface and discharges spontaneously. The acute symptoms may then abate, the fistula closes or remains open and a purulent sinus persists which leads into the frontal or ethmoidal cavities. In the second variety there is a greater or less defect in the orbital bony wall of the frontal and ethmoidal sinuses, and with the orbital periosteum a large abscess cavity is formed, causing marked exophthalmos which usually brings the patient to the eye clinic. In children, the acute perforation takes place through the ethmoidal plate. A curved incision is made along the inner and upper orbital margin, the orbital perios*^ teum and contents are retracted and the opening in the OS planum can then be seen. This should he enlarged, and the adjoining cells curetted according to the amount of disease found present. y.l^^n'^ ^I' Ophthalmology of the Amei-lcan Medical .nine im' ' Session, held at Chicago,