. The Journal of laryngology and otology. onPanas (21), observed anaesthesia of the second division ofthe trigeminus. Rouge (22) infra-orbital neuralgia, Schafer (23),Moreau (24), Hajek (25), and Schroder (26), supra-orbitalneuralgia. Trantas (27) observed complete ophthalmoplegia in 308 The Journal of Laryngology, [June, 1914. ethtnoidal and spheuoidal suppuration, which had begun inthe maxillary antrum. In iri-itation of the trigeminus we mayperceive hyperasmia of the nasal mucous membrane, a smarterconjunctival reaction, ciliary neui-algia, and affection of thesecretory nerves of the eye. D
. The Journal of laryngology and otology. onPanas (21), observed anaesthesia of the second division ofthe trigeminus. Rouge (22) infra-orbital neuralgia, Schafer (23),Moreau (24), Hajek (25), and Schroder (26), supra-orbitalneuralgia. Trantas (27) observed complete ophthalmoplegia in 308 The Journal of Laryngology, [June, 1914. ethtnoidal and spheuoidal suppuration, which had begun inthe maxillary antrum. In iri-itation of the trigeminus we mayperceive hyperasmia of the nasal mucous membrane, a smarterconjunctival reaction, ciliary neui-algia, and affection of thesecretory nerves of the eye. Difficulty and sluggishness of accom-modation, and ophthalmoplegia interna have been referred alsoto a lesion of the oculo-motor—of those fibres, namely, which passthrough the ciliary ganglion to the sphincter pupill^ and to thetensor chorioideas. That in the cases mentioned a causal connexionexists between the lesions of the nerves to the eye and the diseasein the accessory sinuses is proved both clinically and pathologicall3\ ^i. Fig. 1.—Natural size. The thin translucent bony wall of the si^henoidalsinus has been removed, s. s. Sphenoidal sinus, g. Gasserian III. Third division of the trigeminus, t. u. Second division of the tri-geminus, t. I. First division of the trigeminus, a. Abducens. tr. Tro-chlearis. o. Oculo-motor nerve. In purulent inflammation and ulceration of the mucous membraneof the accessory sinuses and in thrombosis of the veins of themucous membrane of the accessory sinuses, the inflammatory pro-cess, when the bony walls are extremely thin, is apt to extendthrough the bone to the dura mater and to the trunks of thenerves to the eye in direct contact with the bone and with thedura, as well as to the vascular sinuses of the cranium. In thisway hyperaemia and inflammation of the nerve-trunks can develop;collections of serum or pus and thrombo-phlebitis of the venoussinuses may exercise direct pressure upon the nerve-trunks, andlastly, destr
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