202 THE HEAD AND NECK 



hypophysis (pituitary body). They are separated from one 

 another by a septum, which is usually deviated to one or other 

 side of the median plane. When these sinuses become infected, 

 the condition may spread upwards in front of the hypophysis 

 (pituitary body) and affect the optic chiasma, which lies above 

 the forepart of the body of the sphenoid , thus giving rise to 

 disturbance of vision. Collections of pus in the sphenoidal 



FIG. 60. -Lateral Radiogram of Skull. The relation of the sphenoidal 

 sinuses to the hypophyseal fossa (selki turcica) is well shown. 



sinus can only be evacuated properly by removal of its anterior 

 wall. This is reached through the posterior ethmoidal cells, 

 which are usually involved, by removal of the middle and 

 superior conchae (turbinated bones). 



Tumours of the Hypophysis (Pituitary Body) have recently been 

 removed through the sphenoidal sinuses. A somewhat U-shaped incision 

 is made round the nose, which is turned upwards after the nasal septum 

 has been removed and the lateral nasal cartilages divided. 



By taking away the superior and middle conchae, better access can be 

 obtained. At a depth of 2^ inches from the surface the resistance of the an- 

 terior wall of the sphenoidal sinuses is encountered, and the wall is lightly 

 chiselled through. The septum between the sinuses is remoyedj and th? 



