Successful removal of two osteomata of the orbit : one originating in the frontal, the other in the ethmoidal cells with a history of osteomata of the neighboring pneumatic cavities of the orbit / by Joseph A. Andrews.

  • Andrews, Joseph A., 1855-1926.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Successful removal of two osteomata of the orbit : one originating in the frontal, the other in the ethmoidal cells with a history of osteomata of the neighboring pneumatic cavities of the orbit / by Joseph A. Andrews. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    48/56 page 48
    of the frontal sinus, and that, consequently, by a free opening of the frontal sinus they might be extirpated, just as a stone is removed from the bladder in lithotomy (see Fig. ii). This statement is certainly incorrect, as is shown by my own case, and those of others which have been accurately described. The published cases of osteomata of the frontal sinuses show that the consistence of these growths differs accord- ing to preponderance of the spongy or the ivory sub- stance. Generally the ivory-like shell preponderates, and there may be only a trace of spongy bone; then, again, in rare cases, the tumor may consist chiefly of a spongy mass, on which ivory bone plates are scattered, making the entire growth softer than normal bone. In the majority of the cases which were carefully observed, the entire surface was covered with a delicate connective- tissue envelope ; in some instances, parts of this envelope were the seat of polypous excrescences, which sprang out of remains of mucous membrane which had atrophied under the pressure to which it had been subjected by the tumor. All osteomata of the frontal sinuses not alone distend, but perforate, the walls of the sinuses; but they do not show a tendency to coalesce with the walls of bone which they pierce—a fact of great practical importance in con nection with the operation for their removal. The perforations take place, most frequently, outward through the anterior plate of the frontal bone, and through the roof of the orbit into the orbital cavity. They rarely project into the nasal cavity. The os planum of the eth moid bone and the lachrymal bone are destroyed in ex- ceptional cases, where the tumor has such a broad base projecting into the ethmoidal cells that the point of origin of the tumor cannot be made out. Perforation through the inner plate of the frontal bone into the cranial cavity is not uncommon, and this may take place, as is shown by Arnold's case, at an early period, when the tumor was not quite as large as a walnut. The cases recorded show
    digitised image 1
    digitised image 2
    digitised image 3