326 



NASAL CAVITIES. 



may thrust on one side the septum nasi and externally cause well-marked 

 asymmetry of the face. Sero-mucous or muco-purulent discharge then 

 occurs. 



The diagnosis is somewhat difficult, for continuous or temporary 

 roaring (or at any rate difficulty of respiration), being the dominant 

 symptom, must be distinguished from roaring due to a laryngeal lesion 

 like paralysis or tumour formation, from perilaryngeal compression due 

 to enlarged retropharyngeal glands, and from tracheal or pulmonary 

 lesions ; and its origin must be located in the nasal cavities. 



Fig. 168. — Transverse section through the nasal cavities : myxoma of the right 

 side and of the maxillary sinus. Deformity of the forehead and face. 



The prognosis is grave, in consequence of the difficulty of exploring 

 the depth of these cavities and of the possible nature of the tumour. 

 Nevertheless, in the case of simple myxomata permanent recovery 

 usually follows extirpation. 



Treatment is confined to extirpation, which is quite possible in the 

 case of pedunculated tumours ; in the case of sessile tumours free 

 trepanation of the roof of the nasal cavities becomes necessary. The 

 operation is quite safe. 



PURULENT COLLECTIONS IN THE NASAL SINUSES. NASAL GLEET. 



From the clinical point of view two varieties of this condition may be 



distinguished — inflammation of the mucous membrane of the maxillary 



