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13
During the greater part of the latter half of the past year, on
the advice of the Ministry, the operation for the removal of tonsils
and adenoids was suspended on account of the epidemic of
poliomyelitis in the London area. This was a very reasonable and
justifiable precaution, for the leading authorities on the subject
have shewn that there is a certain relationship between tonsillec
tomised patients and poliomyelitis. This has been very clearly
demonstrated in special investigations conducted in the United
States, and we have had at least one instance in Walthamstow to
corroborate this decision.
The operation for the removal of tonsils is never an urgent
one, as evidenced by many Hospitals having a waiting list, which,
they say, will take from one to two years to clear. The suspension
of the operation, concurrent with this waiting list, during an
epidemic of poliomyelitis, is done to take every possible safeguard
to protect the patient, and cannot be considered to have any undue
deleterious or damaging effect on the patient's health.
At the Ear, Nose and Throat Clinic it has been the practice
for a number of years to limit the number of tonsil operations to
the very minimum. This decision has been based on the results
observed where tonsils and adenoids have been removed after a
more or less routine fashion. During the period of the epidemic
the recommendations for operations were postponed in all cases.
In no instance to our knowledge have we found any patient to
have suffered any undesirable effect from this postponement. In
the majority of these cases we have resorted to other methods of
treatment along conservative lines, such as tonsil suction and tonsil
painting, and especially to treatment of nasal conditions which are
commonly found in association with diseased or "enlarged" tonsils.
In previous reports we have stressed the importance of the
close relationship between certain nasal affections such as sinusitis,
rhinitis and diseased tonsils, and the necessity of treating these
conditions as a preliminary to any radical surgical treatment of the
tonsils. We wish, again, to emphasise this line of approach to the
"tonsil problem."
One striking fact in the year's returns is the very small number
of cases of chronic otorrhoea. In all, only sixteen cases were seen
at the clinic during the year. This is a remarkably small number
for a school population of the size of Walthamstow. In the past,
chronic "running ear" was one of the commonest complaints
amongst a school population, and one of the most serious. There
cannot be any doubt that the adequate treatment now available
for the successful treatment of "acute discharging ears"— the
forerunner of the chronic type — and the detection and treatment
of nasal defects, always a potential source of ear trouble, in the
younger age groups, has had a most important effect in the prevention
of chronic discharging ears and its inevitable sequelae of
deafness.