Having determined that an external operation on the frontal sinus and ethmoid labyrinth is necessary, there seems to be no question but that the terribly mutilating, truly radical operation of Riedel, with its complete destruction of the supra-orbital ridge, is the one which gives us the greatest certainty of a cure. The resulting deformity is so great that the operation is scarcely ever carried out to-day, but the Killian operation, or some of its modifications, is substituted.
In Riedel's operation1 there are no dead spaces left behind; in Killian's operation,2 the dead spaces, with their subsequent difficult drainage, constitute that element of doubt which does not allow us always to promise a certain cure. Admitting the necessity of an external operation in any given case, how are we to overcome this intrinsic objection of dead space which is the weak point in an otherwise ideal operation?
HORN H. SOME LESSONS DRAWN FROM A SERIES OF TWENTY-EIGHT EXTERNAL OPERATIONS ON FRONTAL SINUS AND ETHMOID LABYRINTH. JAMA. 1911;LVII(10):793–796. doi:10.1001/jama.1911.04260090015009
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