THE TONSILS AS FOCI OF INFECTION IN STREPTOCOCCUS HEMOLYTICUS CARRIERS

Abstract

carefully carried out intranasal work fails to relieve the patient from annoying headache and in cases in which there is a threatened intracranial complication.Such cases will arise only exceptionally in one's experience.Dr. James J. Pattee, Pueblo, Colo.: Frontal sinusitis, requiring operation, is a troublesome affection, and the opera- tion of choice should be determined with care.From a gen- eral survey of the published opinions there is, in my judgment, a progressive increase in the number of intranasal operations with a corresponding lessening of the external.I am in accord with this order of things.I agree with Dr. Sham- baugh that it is applicable in the vast majority of cases.In rare cases we must resort to external measures.The Killian operation fails occasionally, even in the hands of our best operators.It frequently produces much disfigurement and in some cases fails to afford ample permanent drainage, the feature on which its greatest claims are based.Dr. Ingals' statement is very true.The intranasal operation requires intimate anatomic knowledge and much experience.The narrowest part of the nose is on a plane with the canthi.The Lothrop operation has the advantage of opening the sinus very near this point, a great advantage.The Lothrop opera- tion permits of thorough work; establishes adequate drainage; affords the best vision, and offers the most direct route to the site of greatest difficulty and danger.It permits healing in the shortest time and minimizes untoward after-effects.