Henry L. Williams

LXXXVII Lethal Granulomatous Ulceration Involving the Midline Facial Tissues

From time to time there has been presented before this society a group of granulomas having their primary site in the tissues of the nasal chambers or palate, usually running an indolent course for a year or two, sometimes even appearing to heal for a short time but again breaking down for no obvious cause. After a few months to a few years the lesion becomes more active and invades the neighboring bony structures, destroying the nose, palate and maxillary air sinuses, frequently with preservation of the upper lip, resulting in a shocking facial deformity. These patients die either from pure exhaustion or from hemorrhage.

XXXII Diagnosis and Treatment of Chronic Disease of the Paranasal Sinuses

The fundamental requirement in the treatment of chronic sinusitis is a differential diagnosis exact enough to prevent the application of formidable surgical procedures to conditions for which they cannot logically be expected to produce any beneficial effect. It is lack of attention to this important detail that has had the effect of bringing surgical procedures, directed against chronic suppuration in the paranasal sinuses, into disrepute among the uninformed physician and layman, not, however, without justification.

Roentgen Therapy for Acute Sinusitis

In June 1940 we presented a preliminary report of our experience in the use of roentgen therapy for acute sinusitis (6). We have since continued the use of this method of treatment and shall present in this paper a comparative study of the preliminary report and recent results. Since the treatment of acute sinusitis with roentgen rays is relatively new, we believe that a brief review of the literature is indicated. Dysart (2) in 1939 and Gatewood (3) in 1940 published extensive reviews of the literature on the use of roentgen therapy in otolaryngology. Dysart, who was seemingly in favor of the method, was able to discover many reports favorable to this mode of treatment. Gatewood, on the other hand, reported many unfavorable observations. It is interesting to note that only in an article by Heidenhain and Fried did either author duplicate the others review. For this reason one article is an excellent supplement to the other; between them they cover the literature so thoroughly as to render any duplicatio...

XXIII Sulfonamide Therapy for Acute Otitis Media and Mastoiditis

With the introduction of new therapeutic agents such as the sulfonamide compounds, the technic for successful application of them must be slowly worked out by clinical trial. One of these compounds itself may produce certain ill effects which place an additional burden on the physician. Naive dependence on the compound may lull the usual watchfulness of the physician for the development of complications and thus work to the disadvantage of the patient.

The Differential Diagnosis of Vertigo

in vestibular function anywhere in the peripheral or central vestibular system (labyrinth, vestibular nerve, brainstem, cerebellum, cortex). Etiology of vertigo includes familial, infectious, neoplastic, metabolic, toxic, vascular, autoimmune, and traumatic causes. Distinguishing the site and cause of lesion resulting in vertigo is important because some causes of central vertigo can be life threatening and require immediate attention.

LIII The Underlying Factors Concerned in Otitic Hydrocephalus

With the increasing number of cures of septic otitic meningitis, both through the agency of sulphanilamide and other methods, we may expect hydrocephalus to become a problem confronting the otologist more and more frequently. In reviewing the literature of so-called otitic hydrocephalus, it is at once obvious that it is not an isolated pathologic phenomenon associated with disease of the ear, but an example of that great group of intracranial hypertensions on an inflammatory basis considered in the literature under the various names of serous meningitis, meningitis sympathica, ventricular meningitis, acquired hydrocephalus, cerebral pseudo-tumors, pseudo-brain abscess or otogenous encephalitis. It is impossible to draw a definite line of demarcation between the acute, the subacute, the recurrent cases of otitic hydrocephalus or aseptic meningitis on the one hand and chronic hydrocephalus on the other. The one grades into the other, both in symptomatology and pathology. It therefore becomes necessary, in fulfilling the requirements imposed by the title of this paper, to consider briefly the anatomy, physiology and pathology which might have a bearing upon the production and absorption of the cerebrospinal fluid, and any alterations in any or all of them tending to produce a state of intracranial hypertension.