The closing words by Dr. O. T. Freer1 in his recent article on the intranasal operation on the frontal sinus for the cure of chronic suppuration were as follows:
In cases where with the sinus open for drainage, marked suppuration continues after the intranasal operation, the external operation must be resorted to. Where great swelling of the lids, exophthalmos or cerebral symptoms indicate the existence of caries of the sinus wall and progress of the disease beyond it, in the form of Killians' sinusitis frontalis, the intranasal operation should not be done.
That is my belief with the exception that I should like to modify and amplify his remarks. When he says the external operation must be, I say should be done, because I have a very vivid recollection where I insisted that the external operation be performed and subsequently wished I had not been so insistent, although a
BECK JC. EXTERNAL FRONTAL SINUS OPERATION. JAMA. 1916;LXVII(25):1811–1815. doi:10.1001/jama.1916.02590250013003
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