. Surgery, its principles and practice . hat they may be successfully treated by applications of liquid air. Inrare instances encapsulated sarcomata, endotheliomata, and certain non-malignant growths, especially in the anterior portion of the orbit, maybe reached without sacrificing the eyeball, according to a method advo-cated by Lagrange and Knapp, namely: first severing, if, for example, itis on the inner side, the internal and perhaps the inferior rectus, which aresecured with threads, next separating the conjunctiva, and graduallydissecting out the growth through the opening thus made. Af
. Surgery, its principles and practice . hat they may be successfully treated by applications of liquid air. Inrare instances encapsulated sarcomata, endotheliomata, and certain non-malignant growths, especially in the anterior portion of the orbit, maybe reached without sacrificing the eyeball, according to a method advo-cated by Lagrange and Knapp, namely: first severing, if, for example, itis on the inner side, the internal and perhaps the inferior rectus, which aresecured with threads, next separating the conjunctiva, and graduallydissecting out the growth through the opening thus made. After con-trolling the hemorrhage the severed recti muscles are sewed in placeexactly as in the operation of advancement. Generally, however, growthsof this character are reached more easily by resection of the orbital wallin the manner presently to be described. Orbital cysts, dermoids, serousor blood cysts are treated in the same manner as growths, the dissectionproceeding either through an incision along the orbital margin, or, if con-. FiG. 474.—Purulent Disease of Ethmoid and Frontal Sinus,WITH Fistulous Opening at Inner Angle of Orbit (froma patient in the University Hospital). OPERATIONS ON THE ORBIT. 907 ditions are favorable, through the conjunctiva, great care being takento remove every particle of the cyst wall, often a difficult procedure. Oc-casionally a serous cyst may be cured by simply evacuating its contentsand creating, as Buller suggests, a reactive inflammation by the intro-duction of a crystal of iodin. Exostoses and osteomas growing from the wall of the orbit, or push-ing their way into it from the ethmoid or frontal sinus, may be reachedby an ordinary dissection through an incision along the orbital margin,with the usual precautions to avoid the pulley of the superior oblique,the tendon of the levator, and the lachrymal gland. When the bodyof the growth is fully exposed, it may be chiseled from its position in theordinary manner, or if it is very dense an
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