Anatomical researches on the deviations of the nasal septum : study of the difficulties which they occasion in operations, and especially in the catheterization of the eustachian tube, explanation of a new method for overcoming them / by B. Loewenberg.

  • Lœwenberg, B. (Benjamin), 1836-
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Anatomical researches on the deviations of the nasal septum : study of the difficulties which they occasion in operations, and especially in the catheterization of the eustachian tube, explanation of a new method for overcoming them / by B. Loewenberg. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    14/24 (page 33)
    liquid reaches the nasal pharynx superabundantly, and thence passes, behind, into the narrowed nasal fossa. The effect of the contraction of the passage is an augmentation of resistance and of lateral pressure upon the nasal and pharyngeal walls, and finally the liquid may invade the Eustachian tube and even the tympanic cavity. If too strong a pressure be used (a syphon hung too high above the head of the patient, for example), and a liquid too cold, too warm, too concentrated, or not enough so, a violent otitis media may result from this penetration of the liquid into the cavity. In my opinion, such imprudences as these have prevented distinguished aurists, particularly in America, from making use of this process, which I believe to be excellent, on con- dition of employing it according to the following direc- tions : Injection with gentle pressure (I prefer the use of a syringe, the stream of which can be immediately stopped or checked); tepid liquids, consisting of weak solutions; straight position of head of the patient. Necessity of thor- oughly teaching the method and having the person in charge of making the injections practise it before me. In cases of considerable deviations, inject only by the narrowed side. E.—Catheterization of the Eustachian tube. At the beginning of this article I dwelt upon the importance of a free nasal passage, for Eustachian catheterization. We have also seen that one must not be satisfied, in this matter, to speak, as many classical works do, in a general way, of deviations of the septum; but examining the question more closely, as we have above,we must distinguish between the different groups of these anomalies. We will now ap- ply the results of my investigations to this special point. We must first eliminate the horizontal deviations, which I call the superior. Not bearing at all upon the inferior nasal meatus, they could not impede catheterization, which has this canal for its field of operation. On the other hand, I think I have found in inferior devia-