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INTRACRANIAL PATHWAYS OF INFECTION FROM DISEASES OF THE SPHENOID AND ETHMOID SINUSES

INTRACRANIAL PATHWAYS OF INFECTION FROM DISEASES OF THE SPHENOID AND ETHMOID SINUSES Abstract The pathologic process and the pathways of intracranial infection from the paranasal sinuses have not been investigated as routinely or as thoroughly as those of the mastoid bone and petrous pyramid. Except for gross examination at the necropsy table, little effort has heretofore been made to study the sinuses microscopically even in cases of bacterial meningitis of undetermined pathogenesis. Since in only a small percentage of instances is the lesion visible macroscopically, a large number of lesions starting in the sinuses have undoubtedly been overlooked and the primary foci not discovered. It was once assumed that in the presence of suppuration of the middle ear the meningitis was otitic in origin even though pathologic proof of this origin did not exist. During the past seven years, we have been removing the paranasal sinuses en bloc in all cranial autopsies in cases of meningitis. The block consists (fig. 1) of the References 1. Turner, A. L., and Reynolds, F. E.: Study of Paths of Infection to Brain, Meninges, and Venous Blood Sinuses from Neighboring Peripheral Foci of Inflammation: Acute Suppuration in the Accessory Sinuses; Cavernous Sinus Thrombosis; Acute Leptomeningitis; Death; Autopsy, with Microscopic Examination of Ethmoidal and Sphenoidal Air Sinuses and Cavernous Blood Sinuses , J. Laryng. & Otol. 43:565 ( (Aug.) ) 1928. 2. Hesse, W.: Zur Ätiologie der Keilbein-Osteomyelitis , Arch. f. Ohren-, Nasen- u. Kehlkopfh. 137:94, 1933. 3. Kramer, R., and Som, M. L.: Actinomycosis of the Sphenoid with Actinomycotic Meningitis and Brain Abscess , Ann. Otol., Rhin. & Laryng. 44:973 ( (Dec.) ) 1935. 4. Jacobsgaard, J.: Pathologisch-anatomische Beiträge zur Frage nach den Fortleitungswegen der rhinogenen Meningitis , Ztschr. f. Laryng., Rhin., Otol. 26:387, 1936. 5. Turner, A. L., and Reynolds, F. E.: Study of Paths of Infection to Brain, Meninges, and Venous Blood Sinuses from Neighboring Peripheral Foci of Inflammation: Nasal Mucous Polypi; Intranasal Operation on the Ethmoid Sinuses; Purulent Leptomeningitis; Death; Autopsy, with Microscopic Examination of Olfactory Nasal Mucous Membrane, Ethmoidal and Sphenoidal Air Sinuses and Meninges , J. Laryng. & Otol. 42:525 ( (Aug.) ) 1927. 6. Hajek, M.: Ein Beitrag zum Studium des Infektionsweges bei der rhinogenen Gehirnkomplikation , Arch. f. Laryng. u. Rhin. 18:290, 1906. 7. Zwillinger, H.: Die Lymphbahnen des oberen Nasenabschnittes und deren Beziehungen zu den perimeningealen Lymphräumen , Arch. f. Laryng. u. Rhin. 26:66, 1912. 8. Turner, A. L., and Reynolds, F. E.: A Study of the Paths of Infection to the Brain, Meninges, and Venous Blood Sinuses from Neighboring Pharyngeal Foci of Inflammation: Suppuration in Right Posterior Ethmoidal and Sphenoidal Sinuses; Orbital Abscess; Cavernous Sinus Thrombosis; Acute Leptomeningitis: Operation; Death; Autopsy , J. Laryng. & Otol. 41:442 ( (July) ) 1926. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

INTRACRANIAL PATHWAYS OF INFECTION FROM DISEASES OF THE SPHENOID AND ETHMOID SINUSES

Archives of Otolaryngology , Volume 32 (4) – Oct 1, 1940

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Publisher
American Medical Association
Copyright
Copyright © 1940 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1940.00660020749008
Publisher site
See Article on Publisher Site

Abstract

Abstract The pathologic process and the pathways of intracranial infection from the paranasal sinuses have not been investigated as routinely or as thoroughly as those of the mastoid bone and petrous pyramid. Except for gross examination at the necropsy table, little effort has heretofore been made to study the sinuses microscopically even in cases of bacterial meningitis of undetermined pathogenesis. Since in only a small percentage of instances is the lesion visible macroscopically, a large number of lesions starting in the sinuses have undoubtedly been overlooked and the primary foci not discovered. It was once assumed that in the presence of suppuration of the middle ear the meningitis was otitic in origin even though pathologic proof of this origin did not exist. During the past seven years, we have been removing the paranasal sinuses en bloc in all cranial autopsies in cases of meningitis. The block consists (fig. 1) of the References 1. Turner, A. L., and Reynolds, F. E.: Study of Paths of Infection to Brain, Meninges, and Venous Blood Sinuses from Neighboring Peripheral Foci of Inflammation: Acute Suppuration in the Accessory Sinuses; Cavernous Sinus Thrombosis; Acute Leptomeningitis; Death; Autopsy, with Microscopic Examination of Ethmoidal and Sphenoidal Air Sinuses and Cavernous Blood Sinuses , J. Laryng. & Otol. 43:565 ( (Aug.) ) 1928. 2. Hesse, W.: Zur Ätiologie der Keilbein-Osteomyelitis , Arch. f. Ohren-, Nasen- u. Kehlkopfh. 137:94, 1933. 3. Kramer, R., and Som, M. L.: Actinomycosis of the Sphenoid with Actinomycotic Meningitis and Brain Abscess , Ann. Otol., Rhin. & Laryng. 44:973 ( (Dec.) ) 1935. 4. Jacobsgaard, J.: Pathologisch-anatomische Beiträge zur Frage nach den Fortleitungswegen der rhinogenen Meningitis , Ztschr. f. Laryng., Rhin., Otol. 26:387, 1936. 5. Turner, A. L., and Reynolds, F. E.: Study of Paths of Infection to Brain, Meninges, and Venous Blood Sinuses from Neighboring Peripheral Foci of Inflammation: Nasal Mucous Polypi; Intranasal Operation on the Ethmoid Sinuses; Purulent Leptomeningitis; Death; Autopsy, with Microscopic Examination of Olfactory Nasal Mucous Membrane, Ethmoidal and Sphenoidal Air Sinuses and Meninges , J. Laryng. & Otol. 42:525 ( (Aug.) ) 1927. 6. Hajek, M.: Ein Beitrag zum Studium des Infektionsweges bei der rhinogenen Gehirnkomplikation , Arch. f. Laryng. u. Rhin. 18:290, 1906. 7. Zwillinger, H.: Die Lymphbahnen des oberen Nasenabschnittes und deren Beziehungen zu den perimeningealen Lymphräumen , Arch. f. Laryng. u. Rhin. 26:66, 1912. 8. Turner, A. L., and Reynolds, F. E.: A Study of the Paths of Infection to the Brain, Meninges, and Venous Blood Sinuses from Neighboring Pharyngeal Foci of Inflammation: Suppuration in Right Posterior Ethmoidal and Sphenoidal Sinuses; Orbital Abscess; Cavernous Sinus Thrombosis; Acute Leptomeningitis: Operation; Death; Autopsy , J. Laryng. & Otol. 41:442 ( (July) ) 1926.

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Oct 1, 1940

References