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This review covers a survey of almost 600 articles written since October, 1929. It is gratifying to note that more is being written on the pathology, embryology and bacteriology of the sinuses. The maxillary antrum, as usual, is the sinus about which most is written. More and more attention is being paid yearly to the importance of the pulmonary complications due to infection of the upper respiratory tract. ANATOMY, PHYSIOLOGY AND EMBRYOLOGY Fiol has made an extensive research into the anatomy of the accessory sinuses. His articles are richly illustrated with drawings, photographs and x-ray plates of dissections and bones. His conclusions are as follows: A. Relating to the Maxillary Sinus 1. The maxillary sinus does not open directly into the nasal fossa but into the oval foset, and in this way it communicates at the same time with the nasal fossa and with the antero-external

This report concerns the develpoment of an intranasal pack or splint which is made of rubber tissue and is inflated with air when in position. Many attempts have been made to improve the effectiveness of nasal packing either for postoperative use or in the control of hemorrhage while improving the patient's comfort. All of these efforts have been appreciated by the surgeon, but the latter consideration chiefly influences the patient. Discomfort and often pain make the patient dread the period following a nasal operation. The factors which limit the problem are well known, viz., the sensitivity of the nasal mucosa to foreign material, the small size of the vestibule in comparison to the size of the nasal fossa, the irregular and intricate contour of the fossa, the variation in the contour and size of one fossa with that of its partner and with that of other nasal fossae

There are three turbinate bones in each nasal fossa, with an anomalous fourth one present at times. They serve to keep the nasal passages moist and to act as a protective barrier against foreign bodies and other minute particles. Physiologically, they are closely related to the circulatory and neurogenic systems. Because of this, they are subject to a wide range of anatomic changes. In addition, the inferior and middle turbinates have a mechanical function. Anatomically, they are shelves suspended from the lateral nasal wall. In this way they serve as modified drain gutters conveying secretions in the proper direction. This mechanical directing influence is of paramount importance in relation to the secretions of the paranasal sinuses, whether these secretions be physiologic or pathologic. A study of the nasal wall of a wet or dry anatomic specimen demonstrates readily the turbinate shelves, their influence on the directing of secretions

This study is based on the examination of so-called bleeding polyps of the nasal fossa in an effort to determine whether they are nonspecific edematous polyps associated with dilatation of the vessels and secondary hemorrhage, or fibroangiomas, or whether they may be classified as pyogenic granulomas. As far as the literature is concerned, no general agreement has been reached as to the nature of the so-called bleeding polyps of the nasal fossa. The principal point of dissension is whether they are benign fibrovascular tumors or inflammatory masses. 1 Most of the investigators have favored the neoplastic theory; yet there are on record numerous instances of bleeding polyps of the nasal fossa diagnosed histologically as granulomas, as simple, nonspecific inflammatory masses or as granulation tissue. However, in 1936, Simonetta and Tavani 2 were the first to show the similarity of the bleeding polyp of the nasal fossa to the pseudobotryomycoma, a synonym for

A fungus was discovered in pus washed from the maxillary sinuses of a patient during the routine examination of such material. The forms of this organism first encountered resembled body cells so closely that their significance was passed over until forms encountered later made their identity certain. This organism was observed over a period of several months during which time it underwent certain morphologic changes. It was exposed to antiseptic solutions which were instilled into the sinuses in an effort to eradicate the infection. The presence of chronic inflammatory changes in the nasal membranes associated with this unusual type of infection is of considerable interest. There is some evidence to the effect that fungi may cause pathologic changes in the membranes of the nasal fossa. Duverger 1 reported a case of aspergillosis of the nasal fossa associated with changes resembling caseous coryza (ozena). Dunn 2 and later Deile 3 described

A study of atmospheric pressures in the respiratory tract is not new. In the literature I was unable to find any series or group of collected readings of pressures taken. Unfortunately, much of the work has been done on cadavers and mechanically devised apparatus. One finds sufficient theories but few data to substantiate them. The first part of this paper will concern itself with a series of readings of the changes of atmospheric pressure in the nasal fossa. One of the earliest writers on this subject was Donders.1He plugged one nostril with a piece of tubing and, with the mouth kept closed, took readings for gentle and forced respiration. He stated that the inspiratory or minus pressure averaged − 9 to − 10 mm. of water, while the expiratory or plus pressure measured + 7 to + 8 mm. He assumed the pressure to be the same throughout the

At the fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Chicago, Judson R. Belmont, MD, Manchester, NH, presented his experience with the horizontal maxillary osteotomy as an approach to nasopharyngeal and nasal fossa tumors. Preoperatively, all patients received an apical roentgenogram to insure incisions that were high enough so as not to damage the maxillary dentition. The actual osteotomy was performed as previously described in the orthognathic surgery literature, along with a wire closure and six weeks of intermaxillary fixation postoperatively. While it provides wide exposure for tumor extirpation, the procedure is limited by: (1) possible damage to unerupted teeth, (2) possible disruptions in facial growth, and (3) the requirement for intermaxillary fixation and the attendant risk of iatrogenic occlusal abnormalities.