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.

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    which is seldom painful, must be executed rather quicldy with children and ner^'ous patients, but alwa.>s without precipitation, because from a hasty introduction of the instrument, when the eye cannot follow its point, the external meatus is frequently incised instead of the membrana tympani. Injury to the bulbus venae-jugular, which has been observed twice (Ludewig, Hildebrandtj, occurred through the abnormal dehiscence of the floor of the cavum tympani. They progressed favourably upon quickly tamponing. Immediately after paracentesis in the somewhat gaping incision, a weak pulsation of the fluid or a distinct motion of it will be observed during speech or the act of swallowing. It is only rarely that a small drop of fluid exudes through the orifice to the external surface of the membrane ; frequentl^,•, however, immediately after the operation, especially if the secretion is serous, several bubbles will be seen rising up behind the membrane during an act of swallowing, due to the entrance of air through the orifice. Sometimes a loud cracking noise will be heard in the ear during deglutition, when the margins of the perforation gape. Fig. 120.—Vertical Incision in keont Fig. 121.—Hokizontal Incision in thk OF AND below the HANDLE OF THE ANTERIOR INFERIOR QUADRANT. Malleus. To remove exudation from the tympanic cavity after paracentesis it is necessary to inject air forcibly, and then the full effect of the operation is obtained. In almost all cases it will be possible to drive out the masses of secretion through the incision into the external meatus by means of my method, and that more com- pletely than can be done by Valsalva's method or the catheter. Only in isolated cases, in which the resistance in the middle ear is very great, or in which, in consequence of paresis of the muscles of the palate and of the Eustachian tube, their action becomes insufficient during the act of swallowing, will it be necessary to inject air through the catheter into the tympanic cavity. But it may happen that the secretion can be more easily removed by blowing the nose violently than by the catheter or my method. Eohrer recommends disinfec- tion of the naso-pharynx with a 6 per cent, solution of hydrogen peroxide before using the air-douche. The success of the operation depends chiefly on the complete removal of the secretion from the tympanic canity. It is, therefore, advisable to apply