View report page

A few cases require a more extensive operation, involving removal of some
of the obstructing tissue, together with Straightening, but these latter are few
and far between. In spite of the adverse criticism levelled at these procedures,
I have been unable to find any evidence that they seriously interfere with the
subsequent growth of the nasal tissues, whilst the advantages gained are very
obvious.
No Tonsillectomy and Adenoidectomy will cure nasal obstruction due to
bony or cartilaginous deviation . . . and, if this be left untouched, the Tonsillectomy
and Adenoidectomy will have lost a great part of its value, with serious
consequences to the physical and mental development of the child.
I would point out that many cases of nasal catarrh are cured by
Tonsillectomy and Adenoidectomy.
I still find that nasal guttae Sulfex provides the best type of treatment
for nasal catarrh, especially when acute—suppurative or otherwise, and where
there is no Tonsillar disease or excessive Adenoid growths—but it must be
Vised with caution, as it contains Sulphathiazole—and where this latter drug
is inadvisable, Argyrol or Argotone are helpful. In all Cases requiring operation,
where the Teeth are diseased, I have always urged prior Dental treatment,
except in urgent conditions. Some patients shew marked Tonsillar improvement
after Dental treatment has been carried out. In one Case where Tonsillar
operation had been performed (elsewhere), Tonsillar remains were found on
one side, which looked very unhealthy, but recovered their healthy state
after removal of Dental sepsis.
The epidemic of Acute Poliomyelitis, during the late summer and
autumn, prevented a large number of operations being performed within a
reasonable period, and so has protracted the pathological state of these little
patients—thus rendering the task of cure more difficult. I am still of the
opinion that a second Adenoidectomy should not be performed unless nonoperative
treatment has failed; so very often does nasopharyngeal adenoid
excess diminish to a great extent when the active infection has disappeared—
this Adenoid excess being one of Nature's methods of resistance to bacterial
invasion. A large majority of children with recurrent Adenoid excess shew
great improvement with the use of Nasal guttae Argyrol—5 per cent.—or
some other similar drug. I feel sure that this excess is often encouraged by
nasal obstruction, especially when this has been chronic.
During this last year I have had further confirmatory proof of the
great value of our Speech Clinic in Cases where there is no mechanical obstruction
(often previously removed), thereby promoting the habit of nasal
breathing—and thus indirectly aiding hearing.
It is not an easy matter to distinguish between some Cases of Deafness
due to an aural lesion per se, and those due to cerebral lack of appreciation
—often in combination, for deaf patients gradually lose that "qui vive" so
vital to acute hearing. Some of these children shew great lack of attention
and power of concentration—often with no obvious aural lesion, and these
latter are more successfully treated by Mental rather than Physical means.
The treatment of early Cases of Acute Tympanic suppuration with
Systemic, and sometimes, local Penicillin, is proving successful, and is often
aided by Myringotomy, when there is definite membranic bulging, with lack
of necessary drainage. The value of Penicillin in these Cases must not be
52