=Lodge, Jr., M. D., Samuel.—A Case of Fatal Sphenoidal
Suppuration.=—_The Laryngoscope_, March, 1900.
W. S., aet. thirty-one years, admitted to Royal Halifax Infirmary May
15, 1899, complaining of pain in right ear and right side of face of six
months’ duration. For two months right side face swollen and copious
bloody, purulent discharge from right nostril. Nine years ago had
syphilis. Insomnia from pain.
On admission: Temperature 100°; skin over right superior maxilla red and
œdematous; thick purulent discharge from right superior meatus,
sequestrum in region of right cribriform plate; naso-pharynx, chest, and
abdomen normal; urine, sp. gr., 1014; trace of albumen. Fundi (of eye)
normal.
May 16—No pus found in antrum on exploration and flushing. Patient
taking 60 grs. pot. iod. (t. i. d.) and mercurial inunction. Temperature
in ear usually higher than that in mouth until just before death. June
8.—Mortuus est.
_Post-mortem Examination._—Skull. Base of brain was bathed in thick
greenish pus, principally in the neighborhood of the pituitary body, the
pus extended back over the pons and medulla. No brain abscess.
Ventricles contained more than normal quantity of fluid. Frontal sinuses
and cribriform plate of ethmoid and ethmoidal cells normal.
To right of the sella turcica there was some necrosis of the walls of
the sphenoidal sinus. Probe readily passed from base of skull through
sphenoidal sinus into the nose. Large free opening from said sinus into
nose, which sinus was full of muco-pus. Cavernous sinus not thrombosed.
Right antrum of Highmore contained about a dram of thick glairy mucus.