Diseases of the nose and throat . y detect a diseased sinus and succussion hasbeen mentioned as a diagnostic sign, but it must require an excep-tionallv keen ear to srain anv data of value from either. In some THE MAXILLARY SINUS. 79 cases, especially those of dental origin, the alveolus on the affectedside is swollen, congested and sensitive to pressure. If any doubtremains as to diagnosis we may resort to exploratory puncture witha trocar, either through the inferior meatus, or the canine fossa. Inthe latter case an ordinary small-sized trocar and in the former thecurved antrum trocar design
Diseases of the nose and throat . y detect a diseased sinus and succussion hasbeen mentioned as a diagnostic sign, but it must require an excep-tionallv keen ear to srain anv data of value from either. In some THE MAXILLARY SINUS. 79 cases, especially those of dental origin, the alveolus on the affectedside is swollen, congested and sensitive to pressure. If any doubtremains as to diagnosis we may resort to exploratory puncture witha trocar, either through the inferior meatus, or the canine fossa. Inthe latter case an ordinary small-sized trocar and in the former thecurved antrum trocar designed by Myles will be found should be done with the strictest antiseptic precautions, lest asound antrum be thereby infected (Fig. 35). Hydrogen dioxid in-jected into the antral cavity through the ostium as proposed byMoreau Brown, is relied upon to give its characteristic effervescencein the presence of pus, but should be used cautiously, since the rapidevolution of gas may produce painful distension. Pus may some-. Fig. 35. Myles Antrum Trocar, Canula and Washing Tube. times be seen oozing from the antrum alongside a probe or canulapassed through the ostium. With a Politzer bag attached to thecanula, or air douche, one sometimes succeeds in expelling smallquantities of pus that cannot be washed out by any process of irriga-tion. Secretion may sometimes be sucked out of an affected sinusby the process known as negative politzerization as recommendedby Sestier. The diagnosis may be further confirmed by transillumi-nation of the sinus by means of an electric lamp placed in the mouth(Fig. 36). This test is more satisfactory in a room from which allother light is excluded. Illumination of the face beneath the orbitsis thought by Davidsohn to be less conclusive than that of the eyes,which are usually bright in a normal skull with a clear puncture sometimes fails, owing to extreme density ofthe antral wall, which the trocar cannot penetrate, or to th
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Keywords: ., bo, bookcentury1900, bookdecade1900, booksubjectnose, bookyear1903
