Orbital tumors : results following the transcranial operative attack / by Walter E. Dandy.

  • Dandy, Walter Edward, 1886-1946.
Date:
1942
Catalogue details

Licence: In copyright

Credit: Orbital tumors : results following the transcranial operative attack / by Walter E. Dandy. Source: Wellcome Collection.

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    occasionally enlarged or reduced in size, but the vast major¬ ity of tumors are not continuous through this opening. The dural tumors, which comprise almost one-half of the series, usually but not always show a diffuse hyperostosis of the walls of the skull and orbit. In these cases there is usually no gross defect in the orbital roof, but the extension of the tumor is due to diffuse invasion of the bone. At times calcification may be detected in the intracranial part of the tumor, entirely unsuspected from the clinical data; or a bony prominence may indicate an underlying growth. In none of the tumors has enlargement of the sphenoidal fissure indicated intracranial participation in the tumor. From symptoms alone, intracranial extension of the tumor would have been suspected in perhaps two cases. In Case 12. there was headache but no papilledema, and in Case 14 there were uncinate attacks. The following case, in which operation was performed nearly twenty-two years ago, is presented because it first suggested the procedure now in use. We were then deterred by theoretical possibilities, since found to be of no practical concern. It was feared that a pulsating exophthalmos would follow removal of the orbital roof, but this has never resulted in any of the subsequent cases operated upon by this method. CASE 2-5 D. DHistory numbers 45901, 46599: A twenty-eight-year-old white woman consulted me on July 1, 1918, because of severe headaches, presumably related to an osteoma on the right side of the head producing exophthalmos and marked depres¬ sion of the orbital contents. She had been operated upon by Dr. W. W. Keen, of Philadelphia, thirteen years earlier, at the age of fifteen. He had explored and removed part of the