View report page

24
Residential
schools.
Audiometer.
The first table shows the following points :—
(a) The total number of examinations made during this year, viz., 16,561 children,
representing 21,194 ears, is greater than last year, when there were 14,844 children
representing 17,232 ears. These numbers include only the examinations made at the ten
special aural clinics.
(b) The percentage of cases " cured " is 65. This figure is obtained by deducting the
cases which were lost sight of, viz., 265, from the number examined and treated, viz., 3,320,
and comparing this number with those cases which were " cured."
(c) The average attendance per ear is approximately six.
(d) The proportion of " relapsed cases " is 1 in 6. This proportion is still very high,
though not so high as last year, when it was 1 in 5.
In the Annual Report for 1930 were enumerated the main causes of these relapses, viz., (1)
water entering the ear in some way, and (2) the neglect of ordinary nasal hygiene ; and some of
their many complications were stated. It was also recommended that it should be made part
of the school routine for teachers of all school classes to occupy five minutes at the beginning and
end of both morning and afternoon sessions, in instructing children in the use of the handkerchief
(or its substitute), and the correct method of blowing the nose ; also that part of this time should
be employed in instructing the children in correct nasal breathing.
Since this was written many reports have been received from the assistant aurists of the
great incidence of nasal disease, chiefly catarrh and rhinitis, but also of sinus disease, among the
children who attend the aural clinics for otorrhcea ; and it has been recognised that the root of
the trouble in a large percentage of these cases arises in the nose.
The average number of examinations per session throughout the year works out at about 16
children, representing 20 ears.
The second table shows the number of cases treated for pure deafness unaccompanied by
otorrhcea. Of these, 24-7 per cent, were relieved completely of their defect of hearing, 25-6
per cent, were partially relieved, 16-6 per cent, were unrelieved, and about a quarter of those
treated were still under treatment at the end of the year.
A large proportion of the deafness in children arises from the condition of the nose, and the
suggestions already made on this subject have importance in regard to deafness.
The third table gives a detailed analysis of all cases of otorrhoea requiring treatment, and it
includes the cases of otorrhcea found in the residential schools and treated at the after-care clinic,
Kentish Town.
It shows the various conditions of the ear responsible for the otorrhoea ; the numbers suffering
from each condition, the number of cases " cured " by ionisation or other method of treatment;
the number requiring a mastoid operation ; those lost sight of and the number still under
treatment at the end of the year.
A striking figure again this year is the number of cases coming under treatment, that have
had a mastoid operation, viz., 506, or about 1 in 7 of the cases seen. Some of these are healing
mastoids fresh from operation for mastoid disease, but most of them are re-infections as a result
of one or other of the causes stated above.
It was found when the Council took over the Poor Law institutions that many cases of
otorrhoea existed in the residential schools and that very little was being done for them. Arrangements
have been made now for these children to be transferred to Andover Home, in the case of
children over 5 years old, and to Hornsey Rise Home in the case of children under 5 years old,
to enable them to attend at the after-care clinic, Kentish Town, for treatment as often as is
considered desirable, and for their re-transfer to their own schools when they are well.
During the past year Mr. Wells has treated from these schools 198 cases of otorrhoea, of which
165 were " cured " ; 9 needed a mastoid operation, and 24 were still under treatment at the end
of the year. The percentage of " cured " cases will be seen to be 83 -3.
In addition to these, 6 deaf cases attended, of which 4 were completely relieved and 2 partially
relieved, 7 who needed operation for tonsils and adenoids, 4 needed removal of wax, 1 needed
removal of a cherry stone, 1 had marked nasal catarrh, was diatolised and cured ; 22 cases
required no treatment of any kind.
Since the residential school cases have come under Mr. Wells' care, he has treated 279 cases
of otorrhoea from these schools, of which 239 have been " cured," giving a percentage of 85 -6.
An audiometer, which is an instrument for the detection and accurate measurement of defective
hearing extending over a wide range, was obtained at the beginning of 1931. It provides,
by means of a gramophone record, a voice which dictates figures, commencing loudly and gradually
fading away to a very soft note over a measured range. It is capable of testing any number of
persons up to forty at a time. Those being tested apply headphones to the ear, first on one ear
and then on the other, and as the voice is heard calling out the figures, these are recorded on charts
which contain suitable tables, with spaces in which to enter the numbers as they are called out.
When the person being tested fails to hear the softening voice, he either enters a wrong number
or fails to make an entry in the proper space ; and, by examining the chart, the number of units
of defect of hearing is seen at a glance.