Structure of turbinated bones: suppuration or abscess, obstructed
breathing, treatment, puncture, plugging, injection, trephining.
The turbinated bones are two fragile bony structures attached to the
outer wall of each nasal chamber. The posterior half of each bone closes
the corresponding nasal sinuse; the anterior half is rolled upon itself
as a sheet of paper might be, and is accordingly open along one side. In
this latter a collection of pus may result from severe inflammatory
action and the resulting discharge may become somewhat chronic. The flow
is greatest after the nose has been raised, from the pus having
previously gravitated into a sac in the lower end of the bone. The pus
may moreover pass backward into the larnyx from the raising of the head
and induce a violent fit of coughing. Sometimes the inflammation has
extended to the bones covering the nose which are bulging and tender.
The thin turbinated bone gives way under the distension, bulges into the
nose, and often stops the passage of air through that side. This symptom
and the appearance of the swelling cause a close approximation in
symptoms to nasal polypus. The facts that it supervened on a severe
_coryza_, that it fluctuates on pressure if within reach of the finger,
and that pus escapes when it is punctured, exclude the idea of polypus.
_Treatment._ Puncture of the abscess inside the nose, plugging and daily
astringent injections will usually rapidly cure. Gamgee, Jessen and
others, recommend trephining of the bone above the nose and washing it
out daily, adding that an extensive removal of the bone will correct any
existing bulging and deformity.