LXXXVII. The Diagnosis and Conservative Treatment of Sphenoid Suppuration

Excellent but few contributions have been made to the literature on the subject of sphenoid suppuration, and comparatively little original work has been done during the past several years. The sphenoid sinus, as is well known, is obscurely located, and although it is only -a small part of the respiratory mechanism it nevertheless merits special attention.' Suppuration may involve the sphenoid separately, but is usually associated with an ethmoid involvement. Infection involving this sinus, with or without posterior ethmoid involvement, is most difficult and one of the rarely diagnosed of sinus infections." The reason for this is apparent when one considers the mild and ofttimes vague symptom complexes together with the almost inaccessible location of these cavities. No doubt some sphenoids with a low grade infection have escaped detection for years, having been considered merely a chronic catarrhal condition, until the sudden appearance of a severe ocular disturbance or another complication invited immediate attention. Of all the sinus suppurations, the sphenoid is probably most dangerous, because of its being surrounded by the meninges, the cavernous sinus and its contents, the carotid artery, the hypophysis and the optic nerve and chiasm. Therefore, to avoid any serious complications from extension of infections and to expect rapid recovery, early diagnosis and proper treatment are imperative.