Politzer's text-book of the diseases of the ear and adjacent organs... / by Adam Politzer ; translated by Oscar Dodd ; edited by Sir William Dalby.

  • Politzer, Adam, 1835-1920.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Politzer's text-book of the diseases of the ear and adjacent organs... / by Adam Politzer ; translated by Oscar Dodd ; edited by Sir William Dalby. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    195/760 (page 179)
    often combined with diffuse swelling of the walls of the meatus. To complete the diagnosis the epidermic scales which have been cast off must be microscopically examined for micrococci and aspergillus fungus. Prognosis.—The prognosis of idiopathic otitis externa is favour- able, as not only do the acute forms subside without after-effects, but even those chronic cases in which granulations or large polypi have developed recover after their removal. Less favourable is the prognosis of traumatic inflammation and of those caused by corrosion of the walls of the meatus, which may produce stricture and atresia of the meatus, or with carious ulceration of the osseous walls, as the inflammation may spread to the cranial cavity or to the lateral sinus (Toynbee). Treatment.—In acute inflammation, so long as the violent reactive symptoms last, the same palliative treatment is suitable as in acute otitis media. In the idiopathic form antiphlogistics (cold, local bleeding before the ear) are only to be used in the severer forms; in traumatic inflammations, on the other hand, cold applications, .especially Leiter's apparatus, are recommended. With the com- mencement of secretion and shedding of the epidermic scales, local antiseptic treatment must begin. In acute cases it is almost always sufficient, after washing out the ear with a 2-3 per cent, solution of carbolic acid or with a weak solution of Lysol (2 per cent.), to insufflate finely-powdered boric acid, to stop the secretion. In chronic cases, where the swelling is not severe and no formation of granulations in the meatus, boric acid may be tried first. If the effect is not good after a few days, it is better to wash out the meatus with antiseptic solution, and instil boracic alcohol (1 in 20), boracic glycerine (Cresswell, Baber), sublimate alcohol (0'05 in 50), or iodol-alcohol (1 in 20). In obstinate cases this method first proves effectual after several cauterizations with a concentrated solution of nitrate of silver (0'8 in 10-0). After using the medicine the ear should be stopped every time with carbolized cotton. Where ulcers exist, which, in spite of the antiseptic treatment, show no tendency to heal, they should be cauterized several times after anaesthetizing with powdered cocaine.* There remains yet to describe that desquamative inflammation of the external meatus, which is generally chronic in its course and goes on to the formation of cholesteatomons masses in the meatus. To this belong the 'molluscous' tumours of Toynbee and the ' keratosis obturans' of Wreden {A. f. A. u. 0., vol. iii.). These cholesteatomas of the external meatus are * For those inflammations of the auditory meatus complicated with the formation of granulations and polypi, see the section on Aural Polypi,