LXIV. Intranasal Drainage of the Frontal Sinus and Anterior Ethmoid Cells

Abstract

Correct surgery should be founded on physiology and anatomy. It is on this basis that it seems to me some of the well known nasal procedures are wrong; for example, cauterization of septum or turbinates, while the submucous correction of the nasal septum is right.Likewise, in the treatment of acute or chronic frontoethmoidal infections, we should consider two factors, the physiologic functions of the nose, and of the epithelial cilia of the mucous lining. Our efforts should be to aid nature in the restoration of the activity of the parts. As suggested by Smith, Wright and others, the functions of the intranasal structures are fourfold:1. To warm the inspired air. 2. To moisten the inspired air. 3. To filter the inspired air. 4. Olfaction. "They believe that the efficiency of each one of these processes depends to a very large extent upon the regulation of the vascular apparatus; that dilatation of the blood vessels, when it is not carried to a point of rendering the amount of air supply to the lungs inefficient, renders the air when it reaches the pharynx not only warmer and moister, and freer of dust and bacteria, but that by filling the unnecessary space in the respiratory region of the nose, it directs a more copious supply of it toward the olfactory regions."The same authorities believe there is one point on which not enough emphasis has been laid, and that is the action of the epithelial cilia. "The cilia in the maxillary sinus remove "Read before the Chicago Laryngological and Otological Society.