. Diseases of the nose and throat . Fig. 65.—Caseous mass washed out of antrum throughostium maxillare. times the blood-vessels rupture in different places, causing little spotsof ecchymosis. As the disease advances, the membrane thickens,in some cases becoming infiltrated and in others covered with granu-lations. Not infrequently cedematous nodules form, which in timetake on the myxomatous aspect, until clusters of small polypi maybe found hanging round the internal border of the ostium. Kanthackrecords a case of polypoid growth within the antrum. Symondsfound several in one antrum varying be
. Diseases of the nose and throat . Fig. 65.—Caseous mass washed out of antrum throughostium maxillare. times the blood-vessels rupture in different places, causing little spotsof ecchymosis. As the disease advances, the membrane thickens,in some cases becoming infiltrated and in others covered with granu-lations. Not infrequently cedematous nodules form, which in timetake on the myxomatous aspect, until clusters of small polypi maybe found hanging round the internal border of the ostium. Kanthackrecords a case of polypoid growth within the antrum. Symondsfound several in one antrum varying between one and two centi-metres in length. Roth says antral polypi are scarce. In the Annalsof Ophthalmology and Otologij for 1896 I reported a case in whichwhat seemed to be soft polypi were washed out through a largehiatus semilunaris, the nozzle of the syringe being placed in one endof the passage. The accompanying cut (Fig. 65) gives the exact sizeof the largest, after being in alcohol over two years. Microscopical(162). Fig. GO.—Lateral frozen section through the middle region of the Ethmoid cells. 2, Superior turbinated. 3, Middle turbinated. of Highmore. 5, Union, or synechia, between septum and inferiorturbinated. 6, Inferior turbinated bone. 7, Hard palate. 8, Tongue. meatus. 10, Inferior meatus. (From Primroses AnatomicalMuseum, University of Toronto.) CHRONIC DISEASE OF THE ANTRUM OF IIIGHMORE. 165 examination of the same at the present time proves it to be nothingbut a mass of caseous matter, composed of cell detritus and poly-nuclear leucocytes. Cases occasionally occur in which the fluid ofthe pus becomes absorbed and the cellular elements undergo fattydegeneration. This is the caseous form of the disease, and it is ac-companied by numerous bacteria, such as staphylococcus pyogenesand sometimes Aspergillus fumigatus. Sometimes in advanced cases the periosteum becomes unusuallyactive, and little juttings and spiculse of bone will grow a
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