. The Journal of laryngology and otology. symptoms with caries of the temporal bone and diseaseof the outer wall of the cavernous sinus. Lapersonne (16) observedparalysis of the trochlearis in otitis. In purulent otorrhoea,VVadsworth (39), Michel (40) and others observed periodicalrecurrent paralysis of the oculo-motor. In Michels case theperiodic oculo-motor paral3sis disappeared as soon as a largecollection of pus had discharged. Wadsworth explains this Jaly, 1914.] Rhinology, and Otology. 367 clinical appearance as due. to an inflammatory change of tJie duramater in the region of the oculo-
. The Journal of laryngology and otology. symptoms with caries of the temporal bone and diseaseof the outer wall of the cavernous sinus. Lapersonne (16) observedparalysis of the trochlearis in otitis. In purulent otorrhoea,VVadsworth (39), Michel (40) and others observed periodicalrecurrent paralysis of the oculo-motor. In Michels case theperiodic oculo-motor paral3sis disappeared as soon as a largecollection of pus had discharged. Wadsworth explains this Jaly, 1914.] Rhinology, and Otology. 367 clinical appearance as due. to an inflammatory change of tJie duramater in the region of the oculo-motor. Eversbusch (41) con-siders it doubtful whether we are here dealing with an otogenicneuritic change or with a toxic inflammation. In addition to theextension of the inflammatory process a purely toxic effect uponthe nerv^e-fibres cannot be shown at present. Chierici also saw inpurulent otitis media a recurrent paralysis of the abducens, whichpromptly disappeared when the purulent discharge was facilitatedand reappeared twice a. r. o. 2J. Fig. 11.—Natural size. s. s. Sphenoidal sinus, a. Abducens nerve, t. Tri-geminus, cm. Meckels cave. tr. Trochlearis. no. Oculo-motor Internal carotid. Isp. Petro-sphenoidal ligament. /. o. p. Petro-occipital fissure, op. Petrovis bone. Dorello (43) and Baldenweck (44) have sought to refer theindirect otogenic lesion of the abducens to anatomical mentions the direct relationship between the veins of thetympanic cavity and of the inferior petrosal sinus, and Baldenweckrefers to the congenital dehiscences in the bone of the anterior wallof the tympanic cavity. He describes the close relationship of thenerve-trunk to the apex of the pyramid, the abducens being attachedto it by a firm disc of connective tissue, which is further strengthenedby the petro-sphenoidal ligament and by processes of dura. Imme-diately after its transit across the edge of the pyramid the abducenssinks into the cavernous sinus. Dore
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