In the treatment of spheno-ethmoidal sinusitis, whether conservative or radical, we are only too frequently at a loss to explain, not only to the patient but to ourselves as well, the vagaries which we obtain in our results. It is only when we stop to think of the many types of tissues making up the structures of the middle and superior turbinates and the walls of the posterior sinuses, and of the multiplicity of pathologic changes which may take place within this small area, that we begin to appreciate why our results are so confusing.
We ask ourselves, are the referred pains caused by pressure within the sinuses by retained secretions, by pressure on the nerve by edema or scar tissue, by an inflammation of the nerves themselves, by simple inflammation of the mucosa, or by the bone changes? Is optic neuritis the result of similar changes? Has the age