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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    (3,) Irrigation through the natural orifice.—Having applied cocaine to the middle meatus, introduce a syringe with a curved nozzle through the ostium maxillare, and irrigate the antral cavity with a solution of peroxide of hydrogen (10-20 vol.). This method is excellent when it can be carried out, but in many cases it is a very difficult or impossible manipulation. Treatment—The treatment of cases of antral disease requires much care and perseverance on the part of both patient and attendant. In all methods the object is the same, viz., to evacuate the pus and cleanse the antral mucous membrane with some antiseptic and stimulating application. If any polypi or hypertrophies of the mucous membrane obstruct the natural orifice, these must first be removed. There are several alternative methods of procedure :— (a^) A few rhinologists irrigate through the natural ojoening. A special syringe with a curved nozzle or a Hartmann's cannula is directed through the ostium and the solutions injected. If treatment is attempted through this orifice it should be enlarged, and the anterior portion of the middle turbinal may have to be removed so as to allow freer access. Good results have been obtained by daily irrigation of boric acid solution through the natural opening into the antrum. (b,) By irrigation through an artificial orifice in the outer wall in the inferior meatus. This method of Krause and Mickulicz has its disadvantages, since it is difficult to secure good drainage, the floor of the antrum being well below the floor of the nasal passage. Moreover, the orifice is necessarily too small to allow curetting. Figs. i8i and 182. Kraiise's Trocar and Cannula; and Guide. Krause's curved trocar and cannula is probably the best instru- ment to use for perforating the wall of the meatus, after the application of cocaine. The trocar should be made to enter the antral cavity just below the nasal duct and close to the floor