All these patients whose cases are here reported had suffered for years from chronic suppurative ethmoiditis, with abscess breaking into the orbit. Exophthalmos varied from slight to marked protrusion of the eye. The operation performed was practically the one described by Killian.1
In the Massachusetts Charitable Eye and Ear Infirmary, we prefer Krause's trephine for making the opening in the nasal bone and then remove by means of bone forceps as much as is necessary for freer access to the nasal cavity. By this method there is less risk of breaking downward, an accident which probably would be followed by some deformity. Mosher's graduated curette is of great use in the deeper parts of the nasal cavity. In intranasal operations it is of inestimable value.
Great care must be exercised in avoiding injury to the lachrymal sac. Ophthalmologists tell us that injury to the superior oblique muscle is not