40 INFLAMMATION OF THE 



reparation which generally obtains after any part 

 of the maxillae has been lost by necrosis. 



Morbid growths dilate the antrum, and may 

 be mistaken for accumulated fluid. They are 

 either Osseous, Cartilaginous, Fibrous, Encepha- 

 loid. Fatty, or Erectile. Epulis has also been 

 known to penetrate into and distend the cavity. 

 They occur at all ages. As a general rule, the 

 malignant kinds are soft and of rapid growth, 

 while the non-malignant are hard and of slow 

 growth. The lining membrane is also liable to 

 cancerous ulceration. Membranous cysts and 

 efiusions of blood, serum, or pus into the cheek, 

 occasionally compress the anterior wall, and some- 

 times simulate dilatation of the antrum. A careful 

 inquiry into the history of the case, and a judicious 

 use of the grooved ne^edle, will, in most instances, 

 lead to a correct diagnosis* 



, Inflammation of the lining Membrane. 



Inflammation of the lining membrane of the 

 maxillary sinus is not confined to any age ; it is, 

 however, most frequently met with in middle-aged 

 persons of weak or strumous constitutions. Mild 

 forms of the disease, produced by local irritation 

 or catarrh, are by no means uncommon ; but its 

 most severe form, accompanied by efiusion, is 

 comparatively rare. 



Cannes.— it will be remembered that the fangs 



