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May 1926


Author Affiliations

From the department of surgery, the Johns Hopkins Hospital and University Medical Department.

Arch Surg. 1926;12(5):949-982. doi:10.1001/archsurg.1926.01130050003001

For at least a century and a half it has been known that under certain pathologic conditions—infection and trauma—air can pass through a break in the outer wall of a cranial air sinus into the scalp and, gradually traveling in the loosely attached subaponeurotic layer, form air tumors which at times may be of tremendous size (fig. 1). The two sources of these extracranial aerogenous tumors (recorded as pneumatoceles or aeroceles) have been (1) the mastoid cells and (2) the frontal sinus, the former being much more frequent.1 It has also long been known that steady pressure on such gaseous tumors caused them to disappear, the air being forced through the eustachian tube or frontal sinus. Swallowing or coughing would again cause the occipital, and coughing the sincipital, variety quickly to reappear. A number of cases of the occipital type have been cured by treating the opening which leads

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