Transactions . d inner, in involvement of the frontal projection at first is hard and bony, resembling an exostosis,though later it acquires a tense parchment-like feeling, and whenthe bone gives way, crepitation and fluctuation may be a rule, there is no pain, the history being that of a slow butprogressive increase of the swelling, extending over a period ofyears. It is on account of this slow growth that the eye gradu-ally accustoms itself to the change which its displacement occa-sions in its relationship with its fellow, so that there is no diplo-pia, while the optic
Transactions . d inner, in involvement of the frontal projection at first is hard and bony, resembling an exostosis,though later it acquires a tense parchment-like feeling, and whenthe bone gives way, crepitation and fluctuation may be a rule, there is no pain, the history being that of a slow butprogressive increase of the swelling, extending over a period ofyears. It is on account of this slow growth that the eye gradu-ally accustoms itself to the change which its displacement occa-sions in its relationship with its fellow, so that there is no diplo-pia, while the optic nerve, by means of its sigmoid flexure,straightens and does not suffer from the stretching to which itis subjected. The nasal examination is negative. The differentiation of the condition is generally not difficult,for empysema of the sinuses very rarely occasions distension of thecavity, while tumors are rare, and in the event of their being ma-lignant are more rapid in their course and are generally of the retinal vessels with choking of tinthe left eye of a subject with right sided ethmoiditis. lyniphal i( Treatment of Diseases of the Nasal Sinuses. 431 There is, however, often difficulty in diagnosing mucoceles fromsyphilitic disease of the orbit, the writer having within the past twoyears assisted in two operations, which were undertaken for w^hatwere supposed to be mucoceles, which proved to be diffuse gum-matous infiltration of the orbit. One of these cases occurred in thepractice of Dr. Wm. Zentmayer and the other in that of C. Parker. Both were children, the gumma occurring inone instance in the vipper, inner angle of the orbit, in the posi-tion where a distension of the floor of the frontal sinus wasthought of, while in the other there were hard, bony swellings inthe upper and inner portion of both orbits, suggesting a disten-sion of both frontal cells. Thick glairy pus w^as found in thenose of one case, and other evidences of nasal
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Keywords: ., bookcentury1800, bookdecade1860, booksubjectophthalmology, bookye
