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Frank B. Kistner, M.D.
JAMA. 1939;112(1):37-38. doi:10.1001/jama.1939.62800010002009a.
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In the remote past the profession was concerned over the distressing, often tragic, sequelae of progressive exophthalmos, particularly with those caused by hyperplastic goiter. With the development and progress of goiter surgery it seemed that the problem had been solved, but there remained a small percentage of patients with this condition who were not relieved, some even continuing a progressive course after surgical treatment of the goiter. I have also had an occasional idiopathic case.

Various procedures were suggested and carried out for the relief of these patients with little or no success until Naffziger and Jones1 in 1932 reported the successful result of operation in six cases in the previous two years and established the principal etiologic factor in this condition. Naffziger's2 article had a very complete bibliography on the subject of exophthalmos.

Swift3 in 1934, entering the orbit by a modified Kroenlein approach for a


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