Diseases of the nose and its accessory cavities.
- Watson, W. Spencer (William Spencer), 1836-1906.
- Date:
- 1875
Licence: Public Domain Mark
Credit: Diseases of the nose and its accessory cavities. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![CASE XVIII. The Author's Case of Necrosis of the Orhitar Plate of the Frontal Bone following'an acute Abscess of the Frontal Sinus. J. E. L. , aged thirty-two years, a jDerfumer's assistant,,married, had always been in good health, neve]- having had a day's illness, and never having had any venereal or other disease, till January, 1874, when he was suddenly seized with severe pain in the head, forehead, and across the eyes. He had not had any fall or injury, nor was he aware of any- thing having happened to him likely to have produced this condition. The j)aiu he describes as having been so severe that he was unable to keep still for a moment, but kept rolling himseK about in agony. In a day or two this was succeeded by swelling, redness and heat of the forehead and eyelids, and it was supposed that he was suffering from erysipelas, and at length a swelling formed over the inner side of the right orbit, and at last broke. From the time of the outbreak of erysipelas, and up to the time that I first saw him in April, he w-as very frequently annoyed by the presence in his nostrils of some very foul-smelling discharge, but no bone had escaped. When seen by me, on April 29th, 1874, there was a swelling of about the size of half a walnut immediately under the inner extremity of the superciliary ridge, the skin over this being red and inflamed, and perforated near its centre by a sinus, from which a thick foul-smelling pus was constantly flowing. On probing this sinus I found several pieces of bone lying loose in the frontal sinus. I therefore suggested that an ojDeration should be ]3erformed for the removal of these sequestra. Bichloride of methylene was given, and the sinus was then enlarged and two fragments of bone easily drawn out. The larger of the two pieces was about three-quarters of an inch across, about tlie thickness of an egg-shell, and concavo-convex in form. Having compared the fragments with the bones in this region, they evi- dently came from the orbitar plate of the frontal at its junction with the inner extremity of the superciliary ridge. Very free arterial haemorrhage followed the removal of the dead bone, but this was easily controlled by pressure. The cavity was dressed with dry lint. In a few days all the swelling had subsided, and, by the use of car- bolic acid lotion as an' injection, all offensive odour was soon destroyed ; healthy granulations sprang up, and the wound gradually contracted, leaving a depressed cicatrix, however, and a fistulous opening that only closed about the end of August or early in September. When seen in October no opening reniained, the general health was very good, and there was no distortion of the eyelid, as I had aX one time anticipated. He still occasionally notices an offensive smell coming into his nostrils from the part.](https://iiif.wellcomecollection.org/image/b21204561_0420.jp2/full/800%2C/0/default.jpg)
