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22
Zinc ionization is the standard treatment which was found most
successful for the majority of cases of chronic otorrhoea but in
the case of post-operated mastoids it is not always successful. I
have found in these long standing operated cases a considerable
improvement with the use of some new 'antiseptic' drugs such as
Chronalgicin, Chloromycetin, etc., applied locally in the operation
cavity after the necessary cleansing out. The best treatment for
chronic ear discharge, is its prevention and in this connection 1
wish, again, to stress the importance of the adequate treatment of
ear discharge in its earliest stage to prevent both chronic discharge
and its usual sequel, impairment of hearing.
A considerable number of patients referred to the clinic for
such common conditions as frequent colds, recurring sore throats,
deafness, nasal obstruction and mouth breathing, etc., have been
found to be suffering from nasal sinus infection. The incidence of
sinus infection amongst children complaining of the above symptoms
is much greater than is commonly suspected. This can be
explained by the fact that the cardinal signs of nasal infection are
not always obvious and can be discovered only on a detailed examination
and a test wash-out of the sinuses. A number of these
cases were found at the clinic during the year and all were very
satisfactorily treated by Proetz nasal displacement method, using
weak ephedrine, warm normal saline, albucid, etc., solutions.
Correctly employed this is a valuable method of treatment besides
its importance in diagnosis.
In suitable cases of nasal obstruction, e.g., hypertrophic
rhinitis, mouth breathing, impaired hearing, etc., I have extensively
used, as in previous years, Gautier's nasal diastolization
method. The results in suitable cases are excellent and the improvement
in hearing in cases of deafness of certain types is
remarkable as compared with the usual methods of syringing the
ears, nose drops, Politzer inflation and the removal of tonsils and
adenoids, which in the majority of instances, do not appear to
shew any improvement.
I will only briefly refer to the subject of the removal of tonsils
and adenoids. The principle here remains the same as reported
at some length in past years. The tonsils should not be removed
until a thorough and detailed examination is made of the nasal
cavity, nasal sinuses and other possible factors, to exclude any
possible primary source secondarily affecting the tonsils. In the
majority of instances when such exciting factors are located and
treated, the 'tonsils' subside without further trouble. The indication
for the removal of adenoids is 'absolute' i.e. when they are
found, definitely, to be a cause of nasal obstruction.