Diseases of the upper respiratory tract : the nose, pharynx and larynx / by P. Watson Williams.

  • Williams, P. Watson (Patrick Watson), 1863-1938.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Diseases of the upper respiratory tract : the nose, pharynx and larynx / by P. Watson Williams. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    THE ACCESSORY SINUSES OF THE NOSE. A fairly accurate knowledge of the anatomical conformation and relations of these accessory sinuses is essential in rhinology ; it will therefore be necessary to refer somewhat fully to the numer- ous features of clinical importance which the}' severally present. The Maxillary .Sinus (Antrum of Highmo're). To show the antrum of Highmore, the malar process has been removed from the skull in Plates III and XXV, and Plates A''AV and A'A'F///display' the antrum in coronal sections. The antrum is a three-sided pyramidal cavit}' hollowed out of the body of the superior maxillary bone, its base being formed by the outer wall of the nasal fossa and its apex by the malar process. The roof is formed by the floor of the orbit, the floor by the hard palate and the alveolar process, the anterior wall by the facial and the posterior wall by the zygomatic surface of the superior maxillary bone. Reference has already been made to the apet-ture of communi- cation with the nasal passage beneath the middle turbinated body. In a number of subjects, about lO per cent, according to Zuckerkandl, there is an accessory ostium in the mucous mem- brane closing in the large bony aperture ; it is below the un- cinate process of the ethmoid, behind the ostium, and un- covered b\- the middle turbinated bone. The Jloor of the antrum is uneven from the projection of the sockets of the first and .second molars, and several bony laminai partially subdivide the cavity. These lamina; often interfere with drain- age of pus from the antrum, and the position of the natural aperture shows that a collection of pus will escape more freely from the nose on lowering the head. The relations of the posterior and anterior dental nerves, and of the superior maxillary nerve, which are well displayed in Plate IV, explain the cause of direct and reflex pains in antral disease. If tumours grow in the antral cavity or pus collects Fig. 3. Suction of the mucous mem- brane of the inner wall n( the anlriim, showing that the epithel- ium is cihntcil, and thatlhe mem- brane is rich in ninciparons glands Zuckerkandl).