THE PRESENT STATUS OF INTRANASAL OPERATIONS FOR THE RELIEF OF INVOLVEMENT OF THE OPTIC NERVE

Since those remote days—"l'âge de pierre de rhinologie" 1 —when operation on the sphenoid sinus was first considered impossible and later frightfully dangerous, the tide of optimism respecting surgical results has been subjected to many fluctuations, and much wreckage litters these stormy shores. Ethmoid and sphenoid sinuses alike have suffered from the attacks of overenthusiastic and underskilled operators, who have had little experience with cadavers and less radiologic study and who have torn blindly through middle turbinates and scrambled up a suppurating, unrecognizable mass of cellular debris. Too frequently nasal operation has been advised when other sources of toxic irritation to the optic nerve—tobacco, alcohol, multiple sclerosis, syphilis, the teeth, tonsils, gallbladder and the prostate—have passed unconsidered. Certain observers have maintained that from 50 to 80 per cent of patients with acute optic neuritis will get well untreated except by ocular rest and proper diet in the absence