Essentials of the diseases of the ear arranged in the form of questions and answers : prepared especially for students of medicine and post-graduate students / by E. B. Gleason.

  • Gleason, E. Badwin.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Essentials of the diseases of the ear arranged in the form of questions and answers : prepared especially for students of medicine and post-graduate students / by E. B. Gleason. Source: Wellcome Collection.

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

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    general anaesthesia, it is probably best in all instances requiring the removal of this ossicle to determine the matter before the operation by means of tests already mentioned, and administer ether. After the completion of the operation the edges of the wound in the drum-head are brought together and supported by a small amount of boric acid or iodoform insufflated by means of the pow- der-blower ; and, if necessary, a small piece of sterilized absorbent cotton may be inserted to retain the edges of the wound accurately in contact. Ordinarily the edges of the wound quickly unite, but suppuration has been reported as following the operation in a few instances. What is the prognosis of the operation ? In all intra-tympanic operations, the prognosis is uncertain. Good results have been reported by numerous operators as following sever- ing the incudo-stapedial articulation and mobilizing the stapes with or without the removal of the incus. The prognosis as regards di- minishing tinnitus is much better than that of improving the hear- ing to a useful degree.1 From the published reports intra-tympanic operations seem remark- ably free from risk. In several instances, however, persistent suppu- ration has followed intra-tympanic operations in catarrhal cases. A slight amount of serous discharge for a few days after the operation 1 Of twelve cases operated upon by the author, tinnitus when present disappeared or was greatly alleviated in all, but hearing was only greatly improved in four. In some of the cases vertigo followed the operation, persisting for a few hours, and in one instance for about three days. In one case—that of a bleeder—hemorrhage prevented completion of the operation, but the drum-head was subsequently opened by Simrock's method and the incudo-stapedial articulation severed, with the result of greatly alleviating tinnitus and slightly improving the hearing for the voice. In none of these cases was hearing for the watch permanently improved. In one of the twelve cases the crura of the stapes and a por- tion of its foot-plate were removed. In this instance nausea and vomit- ing followed the operation and persisted for three or four days. Vertigo also caused considerable discomfort for two or three weeks. The hearing for conversation, at first greatly improved, gradually declined, until at the end of two years the improvement, at first manifest to both the pa- tient and her friends, became by no means so apparent. Tinnitus entirely disappeared.