Report of the Edinburgh Ear Dispensary : with notes of one hundred cases of diseases of the ear treated in succession during the first months of 1861 / by Thomas Keith.

  • Keith, Thomas, 1827-1895.
Date:
[1862]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Edinburgh Ear Dispensary : with notes of one hundred cases of diseases of the ear treated in succession during the first months of 1861 / by Thomas Keith. Source: Wellcome Collection.

    8/26 (page 8)
    The appearances on examination are much the same in both ears : the meatus dry and white, and the membranse tympani much thickened and almost com¬ pletely transformed into dense masses of cretaceous deposit. The case was evidently a hopeless one. 9. Loss of Hearing from destruction of Membrana Tympani—Exostosis in Meatus.—James Miller, set. 25.—The hearing is quite lost in the right ear, from which there has been a copious discharge for the last four years. On cleaning out the passage, a small exostosis is visible, growing from about the middle of the floor of the meatus, and projecting upwards by a narrow neck. This growth was not interefered with, though it could easily have been broken off with a pair of forceps, as the deafness was seen to be caused by the condition of the deeper parts,—the membrana tympani being almost entirely removed, and the mucous membrane of the tympanic cavity being thick and very vascular. 10. Chronic Inflammation of Tympanum and Membrana Tympani—Polypi in both Ears.—William Bryan, set. 15; Jan. 8.—About fourteen months ago, had repeated attacks of pain in the right ear, followed by gradual deafness, and after a few weeks by discharge. In about three months the other ear became similarly affected. He now complains of pain in the head, a feeling of pressure in the ears, great depression of spirits, and occasional attacks of giddiness. The watch is heard on pressure on the right ear, and at the distance of two inches from the left. The tonsils are somewhat enlarged, the mucous mem¬ brane of the throat and nose is thick and red; both Eustachian tubes are impervious, and there is profuse discharge from both ears. There is a large polypus filling up the right meatus and projecting externally. The left meatus is much swollen and thickened, and the bottom of it filled up with several small polypi. There is no portion of the membrana tympani visible in either. The larger polypus, which was of a firm consistence, was removed by means of Wilde’s snare. It was attached by a broad base to about the middle of the posterior wall of the meatus. The smaller polypi in the left ear were broken up and destroyed as much as possible. They were chiefly situated in the groove at the inner extremity of the meatus, close to the lower margin of the membrana tympani. 15^.—The remains of the polypi were freely touched by the galvanic cautery. 22d.—Since last week, whether in consequence of fresh cold or of the too free application of the cautery, has got an attack of acute inflammation of the right meatus, which is much swollen and very tender; the stump of the polypus has also swelled up. In the left the polypi have disappeared. The left Eustachian tube is still impervious. 12;th February.—The discharge has now ceased from the left ear. The air enters the middle ear with a gurgling sound. The hearing distance has increased to between four and five feet. In the right, the polypus, which has been occasionally touched with nitrate of silver, has almost disappeared, and the membrana tympani has become visible : its posterior and inferior portion is seen to be granular. Eustachian tube still shut. 25th' November.—After nearly a year this patient is still under treatment from time to time. His case has been an exceedingly obstinate and trouble¬ some one. The granular condition of part of the right membrana tympani was very difficult to get rid of, and after a time it appeared in the left also. The granulations, when destroyed one week by some escliarotic, generally the solid nitrate of silver, had often reappeared by the next. The right Eustachian tube was long in becoming free ; while the left was one week open,—the next shut. The progress of the case was likewise much retarded by occasional acute attacks of irritation in the middle ear, and by attacks of cold in the head, and sore throat; and at one time there was for several weeks a small perforation in the right membrana tympani. Keeping in view, however, that