Transactions . ity. In presenting these two cases of frontal sinus disease, I wouldask you to bear in mind that such cases come under the observa-tion of the ophthalmologist when the orbit has been invaded andthe disease has reached an advanced stage. The Killian opera-tion was performed. In both, the anterior wall of the frontalsinus, the whole roof of the orbit, and the nasal process of thesuperior maxilla were removed; drainage was established intothe nose at the time of operation through the naso-frontal wounds were closed by sutures. Healing by first intentionwas obtained within
Transactions . ity. In presenting these two cases of frontal sinus disease, I wouldask you to bear in mind that such cases come under the observa-tion of the ophthalmologist when the orbit has been invaded andthe disease has reached an advanced stage. The Killian opera-tion was performed. In both, the anterior wall of the frontalsinus, the whole roof of the orbit, and the nasal process of thesuperior maxilla were removed; drainage was established intothe nose at the time of operation through the naso-frontal wounds were closed by sutures. Healing by first intentionwas obtained within a week. In both cases the upper rim of theorbit was carefully preserved; this is important in order to avoiddisfigurement. The photographs show that there is but a veryslight depression in the forehead. The scar in the one case ismerely indicated, while in the other it is scarcely visible. It has been said that Killians operation causes much deformityby depression of the brow, and annoying diplopia by displace-. Fig. I. Gruening: Modern Operation in Frontal Sinus Disease. 235 ment of the ocular muscles. Neither of these unpleasant resultswere observed in my cases. Case I. A. S., aged 18, was admitted to the Mount SinaiHospital on February i, 1906. His present illness began 8 dayspreviously, with frontal headache. Two days later the left eyebegan to swell, and on the third day an operation was performedin one of our dispensaries, but the patient does not know exactlywhat was done. The eye continued to swell and the patientapplied for admission to Mount Sinai Hospital. Here it was found that the left eye was much swollen; thelid could not be raised voluntarily; the eyeball protruded andcould not be moved. Ophthalmoscopic examination negative:vision good. Pus was found in the nose between the septumand the middle turbinal bone, a portion of which had evidentlybeen removed. Examination of the pus showed streptococcipresent. The operation on the frontal sinus was performed on Feb-ru
Size: 1388px × 1801px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1860, booksubjectophthalmology, bookye
