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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    In the chronic cases with exophthalmos and in the other cases with acute perforation which do not improve on the restoration of intranasal drainage, the method of operating is as follows: It is a distinct advantage to remove the anterior half of the middle turbinate a day or two before the external operation, though this pro- ccdiire is condemned by some; thus Killian claims that the virulence of the infection is thereby increased. ] have never seen any ill effects from this preliminary operation. Under morphin-ether narcosis, the external excision is made (Fig. 1) along the upper orbital border mid- way between the eyebrow and the bony orbital margin. Fig. 1.—Showing line of cutaneous incision and (interrupted line) the resection of bone. then down along the inner wall and the side of the nose to the floor of the orbit. This incision in my opinion is preferable to the incision through the e.vebrow (Killian) as it permits external drainage of the frontal sinus if this be found necessary without making another' incision. I have not found that packing the nose with gauze or insertion of a postnasal plug is necessary. The periosteum is divided just at the orbital margin above and in line with the cutaneous incision along the nose. The periosteum is retracted witli a rather sharp elevator. After the firm adhesion of the periosteum to the orbital margin is separated, the soft parts with the orbital con- tents and the lachrymal sac are gently detached and free