View report page

12
The treatment of acute otitis media in its early stages, both in
school and pre-school children has been very successful. We find
the "suction" treatment for acute purulent otitis gives rapid and
excellent results. There is an accompanying rhinitis present in
many of these cases and demands prompt and efficient treatment
simultaneously with the otorrhoea treatment.
We wish that all otorrhoea cases as far as possible be treated at
the daily clinics, where every facility is available for the purpose,
and a thorough cleaning out of the ear can be done both by suction
and cotton wool mopping out and the regular instillation of the
prescribed medicament. It is quite impossible to do this with any
efficiency in the average home and the results obtained by daily
treatment at the clinic as against those where home treatment is
carried out are remarkably better. The early and efficient treatment
of acute otitis is of the utmost importance, firstly to prevent any
permanent damage to the hearing and secondly to prevent the
condition becoming chronic.
A large proportion of the children referred to the clinic as
"nose and throat defects" from the school inspections and minor
ailments clinics was on account of "enlarged tonsils and adenoids."
145 children were seen for this condition alone. In addition a
number of others had "enlarged tonsils and adenoids" in
association with ear and nose affections. Of the 145, only 34 were
referred to hospital for operation. Of these about a dozen had
already made arrangements through their private doctor for hospital
operative treatment, and in these cases we advise leaving the
arrangements as they stand.
On the subject of enlarged tonsils and adenoids, we wish only
to emphasise our recommendations set out fully in previous Reports
to the effect that mere enlargement—unless gross and becoming
obstructive, or large masses of adenoids—is not in itself a clinical
condition for the removal of tonsils. A number of factors have to
be taken into account and of these the most important is the
condition of the nasal accessory sinuses, before deciding on the
removal of the tonsils.
The conservative methods of treatment of tonsils in association
with treatment of any accompanying nasal affection is quite
satisfactory. Usually, for children of seven and over "tonsil
suction" is the treatment we practise and advise. For very young
children, suction is difficult and a course of painting, daily with
Mandl's or other suitable "paint" gives a very satisfactory result,
never forgetting to treat any nasal defect present.
There were during the year about a dozen very chronic sinusitis
cases. A good proportion of sinusitis cases clear up fairly quickly