The cure of chronic suppuration of the middle ear without removal of the drum or ossicles or loss of hearing : with ten cases / by Charles J. Heath, F.R.C.S. Eng., Surgeon to the Throat Hospital, Golden Square, London.

  • Heath, Charles J. (Charles Joseph), 1856-1934
Date:
1906
Catalogue details

Licence: In copyright

Credit: The cure of chronic suppuration of the middle ear without removal of the drum or ossicles or loss of hearing : with ten cases / by Charles J. Heath, F.R.C.S. Eng., Surgeon to the Throat Hospital, Golden Square, London. Source: Wellcome Collection.

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    aditus usually being closed, the perforation healed, and thus the hearing apparatus made safe, some time before the antral cavity has filled and granulated, but though unhealed the discharge given off by the granulations when not irritated by the contact of mucus is so trifling that a piece of wool placed in the concha to cover the tube has been found to be a sufficient dressing. Nine of the cases, abridged details of which are given below, are numbered in the order in which the operations were performed during the four or five weeks which ended on June 17th, 1906. Case 1.—The patient was seven years old; sent up from the country; suppuration three months; cause unknown; no adenoids; a dis¬ charging sinus over the mastoid process ; granulations visible in the tympanum ; perforation at the back of the membrane three-sixteenths of an inch in the longest diameter. At operation : Large cavity in mastoid process continuous with the antrum, filled with granulations and pus; granulations not removed from tympanum; cannula used regularly; perforation healed in 14 days. Hearing before operation watch on contact, after operation seven inches, which for this wratch is excellent hearing. The patient’s hearing is probably improving. She is in the country. A letter dated July 26th, 1906, says that she now hears the watch at 30 inches. Case 2.—The age of the patient was eight years. Suppuration during whole life; foul discharge for years; polypus in meatus hiding membrane; no adenoids. At operation : Very large antro-mastoid cavity, filled with granula¬ tions ; polypus removed from meatus ; large perforation at the back of the membrane. Granulations removed through perforation which afterwards healed in three weeks. Hearing before operation watch on contact; after operation 12 feet. Hearing equal in both ears. A remarkable result. Case 3.—A patient two and a half years old. Suppuration three months. Admitted with swelling behind the ear and a high tempera¬ ture. Adenoids removed. Swelling and temperature abated after one w eek in hospital. Discharged but readmitted at the end of another week with displacement of pinna and usual acute mastoid symptoms. Temperature 100'8 F. At operation: Large antral cavity full of pus and granulations; sinus leading to it through the cortex ; perforation at the back of the membrana tympaifi; granulations seen in the tympanum but not removed. Perforation healed in less than one month; much improved in appearance since operation. Entire drum still visible. Hearing before operation and since, not satisfactorily ascertained, but hears whisper well at a distance in both ears, apparently equally, but watch tests are unreliable for both ears on account of extreme youth* Case 4.—The patient was 29 years of age. Totally deaf in the right ear; six months’ suppuration in the left ear. Hearing steadily getting worse; could only hear a loud shout in the affected ear; labyrinth defective; w atch not heard on contact; most of the membrane gone ; foetid discharge; much pain.