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October 1941


Author Affiliations

Associate Professor of Otolaryngology, University of Michigan Medical School ANN ARBOR, MICH.

Arch Otolaryngol. 1941;34(4):797-808. doi:10.1001/archotol.1941.00660040853012

Although the dictum "Avoid bone work in the treatment of acute sinusitis" must be modified in some instances, it should be diligently observed by every rhinologist. It has been recognized for years that osteomyelitis of the skull, brain abscess and meningitis have developed subsequent to inopportune surgical attacks on acutely infected paranasal sinuses. Hence recent contributions to otologic literature advocating early surgical drainage of the frontal sinuses in cases of acute fulminating infection, such as that which follows swimming and diving, have prompted this report.

In this discussion I shall defend the conservative management of such sinusitis and attempt to present a rationale of surgical treatment based on the pathogenesis of intracranial complications. I shall also present a brief summary of data on 13 patients with sinusitis after swimming admitted to the University Hospital in the past ten years (1931 to 1940 inclusive).

Although many otolaryngologists agree that severe acute

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