66 
TKEPHINING THE FACIAL SINUSES. 
maxillary sinus. On slaughter bony tumours were found “ everywhere, 
all ovei the head. Professor Mettam examined the skull. The largest 
tumour was situated in the left maxillary sinus, and had protruded into 
the orbital cavity. The smaller of the two tumours illustrated (fig. 39) 
vas in the right maxillary sinus. Ten or twelve other smaller tumours 
veie obtained from different parts of the skull, and one the size of 
the fist fiom the body of the inferior maxilla. This last was interesting 
because it had included within it at least one incisor tooth. A tumour was 
also removed from between the bodies of the premaxillse, and one from 
the angle of the left ramus of the inferior maxilla. The three tumours 
last mentioned were attached or included within the bones, but there 
veie no distinct pedicles. The bones in which they were situated were 
1 educed to mere shells. The large tumours photographed were not 
pedunculated at all. Sections resembled ivory. The larger of two was 
16 o cm. in length, and 11 cm. in greatest width. It had a circum¬ 
ference of 40*7 cm. It weighed 4 lbs. 3 ozs., or nearly 2 kilos. The 
smaller tumour was 8 cm. in length, nearly 6 cm. in breadth, and 
weighed 12 ozs. (380 grammes). Part of the surface of the larger 
tumour resembled a growing coral. The remainder of the surface was 
bosselated. An irregular cavity in the interior was filled with decom¬ 
posing animal matter. Although the osteoma was so hard and resistant 
to the saw, yet one half which was accidentally let fall broke into three 
pieces ; the fractures were clean and conchoidal, giving one the impression 
that this large tumour had resulted from the fusion of several of small 
size. The smaller tumour included in its structure a molar tooth .—The 
Veterinarian, March, 1899, p. 174. 
In sheep oestrus larvae sometimes cause disease of the frontal and 
superior maxillary sinuses. In dogs tumours are the commonest cause, 
though pentastomum taenioides plays an occasional part. 
The diagnosis can often be made only by the method of elimination. 
I he first symptom is a one-sided mucopurulent and sometimes ill¬ 
smelling nasal discharge, which may only appear at intervals or when 
the head is depressed, as in disease of the guttural pouch. If the disease 
has been caused through alveolar periostitis, the peculiar odour of a 
decayed tooth will be notable. The submaxillary glands of the same 
side often swell, and the case may be suspected to be glanders. At a 
later stage the hones inclosing the sinus become swollen, and on per¬ 
cussion over the diseased spot emit a duller, less resounding tone. In 
making this test the horse’s mouth must be closed, and the sinus on each 
side struck m turn over exactly corresponding points, using the plain end 
of the percussion hammer or a strong key. Thinning of the bone, so 
that it yields to strong pressure, is sometimes seen in cases of tumour 
growth and in actinomycosis or bothryomycosis. Perforation of the bone 
