. Diseases of the nose and throat . ard, the exit of thepus from the ostium may be verified by examination with the nasalspeculum immediately afterward. CHRONIC DISEASE OF THE ANTRUM OF HIGHMORE. 167 The neuralgias which arise from sinusitis, wherever located, arenot of much diagnostic value. Still, there is an uncomfortable feel-ing, a sensitiveness on pressure, and a tenderness of the affected jawin closing the teeth, any of which may be caused by antral disease,but not by suppuration of the other sinuses. Moreau Brown gives one sign in diagnosis which in my experi-ence has been of little va
. Diseases of the nose and throat . ard, the exit of thepus from the ostium may be verified by examination with the nasalspeculum immediately afterward. CHRONIC DISEASE OF THE ANTRUM OF HIGHMORE. 167 The neuralgias which arise from sinusitis, wherever located, arenot of much diagnostic value. Still, there is an uncomfortable feel-ing, a sensitiveness on pressure, and a tenderness of the affected jawin closing the teeth, any of which may be caused by antral disease,but not by suppuration of the other sinuses. Moreau Brown gives one sign in diagnosis which in my experi-ence has been of little value. He says that after cleansing the pusaway by a pledget of cotton, pressure upon the facial wall of themaxillary sinus will produce its reappearance. The maxillary boneseemed to be uninfluenced by any pressure which it seemed safe tomake. Irrigation is also recommended as an aid to diagnosis. That is,by passing the point of a Eustachian catheter attached to a syringeinto the ostium and washing out the cavity with warm water; the. Fig. 67.—Electric illuminator with flexible shank and cords. pus discharged would indicate the presence of the disease. It may,however, be remarked that when the passage is sufficiently open toadmit the introduction of the catheter the pus can usually be seenissuing from the ostium without the use of the instrument. Exploratory puncture as a method of diagnosis has always re-ceived a certain amount of favor. It is made either through the in-ferior meatus, the canine fossa, or the oral cavity, between the secondbicuspid and the first molar teeth, and internal to them. With allthe present means of exploration at command, it is doubtful whetherpuncture will ever be frequently required in the future. Chiari, ingiving the history of one hundred cases, says that the rhinoscopicexamination gave such excellent diagnostic results that he only re-quired to puncture fourteen times through the inferior meatus, toinsure a correct diagnosis. Of all the aids to
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