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From the Archives of the A
December 2007

A look at the past . . .

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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Ophthalmol. 2007;125(12):1629. doi:10.1001/archopht.125.12.1629

The extraction of teeth rarely causes purulent inflammation of the orbital cellular tissues. Feuer, in his paper published in 1892, reviews ten cases. Hirsch, in 1894, was able to collect twenty-five cases. He remarked, however, that in most cases there had been caries of the teeth, and frequently the extraction had led to improvement in the orbital condition, or even to complete recovery from it. Hirsch considers as pure cases only those of Tetzer, Vossius, Burnett, and Fage, adding three observations of his own, in which the extraction of a carious tooth was followed by septic infection and the speedy development of a retrobulbar phlegmon. Our case is of the same sort. . . . In our case the infective matter passed from the alveolar process into the antrum, and thence through the venous anastomoses into the orbit. In the process the purulent masses rarefied the wall of the nose, and on the sixth day escaped through the right nostril.