64 
EMPYEMA OF THE FACIAL SINUSES. 
A small firm swelling was noted above the right eyelid and a hard, ill-defined 
but somewhat extensive swelling below the chest. The latter was not ad¬ 
herent to the skin. 
The condition had attained the above development in two months despite 
treatment. r 
Extensive oedema of the head sometimes occurs in the horse in petechial 
evei and influenza, and in cattle in malignant catarrhal fever ; it affects 
30 th the head and neck as the result of wounds in these regions. Where 
t le head is held low for considerable periods, as after bruising or sprain of the 
muscles of the neck or painful disease of the cervical vertebras, marked oedema 
may develop, completely transforming the appearance of the animal, while 
swelhngs affecting the nasal mucous membrane and adjacent structures induce 
imculty m breathing. A photograph of such a case is presented in fig. 38. 
11 ns condition demands attention, as, being often accompanied by fever 
it may, on superficial investigation, be mistaken for a symptom of certain 
infectious disorders. Such an error is, however, avoided by consideration of 
the history of the case and the condition of the neck muscles, or the cervical 
vertebras. Marked dyspnoea may necessitate tracheotomy. As soon as 
possible the head should be raised and so maintained. The result is often 
astonishing ; a large swelling of this kind disappeared in a few hours, 
lassage is useful to promote resorption of the extravasated fluid. 
(4.) DISEASES OP THE TEMPORAL AND SUPERIOR 
MAXILLARY SINUSES. 
The mucous membrane of the facial and maxillary sinuses is in direct 
connection with that of the nostrils. In the sinuses it is closely attached 
to the bone, to which it acts as periosteum, and contains numerous small 
mucous glands. Prom its sheltered position this membrane is seldom 
diseased. But when catarrh or inflammation arises, the disease readily 
becomes chronic, for the secretion, finding no regular outlet, remains in 
the cavity and decomposes, irritating the mucous membrane. This 
tendency to chronicity is induced by various causes. 
. 0n clinioal grounds, diseases of the frontal and superior maxillary 
sinuses must be considered together despite their varying characters and 
causes. The following forms are recognised :_ 
(1) Dropsy of the sinus. A serous or mucoid fluid fills one side or 
occasionally both sides of the cavity. There is no marked change of 
the lining mucous membrane. 
(2) Empyema of the sinus. The sinus contains pus; in acute cases 
and m oxen blood may also be present. The mucous membrane is 
thickened, vascular and covered with granulations. 
(3) Tumour formation m the sinus. Carcinomata, sarcomata, osteo¬ 
ma a, odontomata, &c., may be present, accompanied by varying quantities 
of a muco-purulent fluid. 1 
Maxu£,“e 
