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requires close clinical exploration and correction. If left untreated
the general rule is for the hearing loss to become progressive and
permanent. I have found in the examination of a large number of
children with defective hearing, discovered during audiometric
surveys of schools, that in many cases the defect was due to an
unsuspected sinusitis and when the sinus trouble was cured the
hearing was restored to normal without any local ear treatment.
These cases are much more frequent than is usually recognised.
Sinusitis is quite common in even quite young children and is
responsible for many signs and symptoms which are often wrongly
attributed to other sources.
"During the year a number of chronic purulent sinusitis cases
were treated at the clinic. When the condition is diagnosed and this
is confirmed by washing out the sinuses, a course of treatment is
then given which consists usually of Proetz nasal sinus displacement
therapy once a week until the return fluid is clear. The displacement
treatments are carried out at the end of each clinic session.
The results obtained have been remarkably good.
" 'Nasal obstruction,' and this embraces a variety of forms,
is perhaps one of the commonest ailments seen among school
children referred to the clinic. These patients or their parents
usually describe the symptoms in such popular terms as 'chronic
catarrh,' 'nose always stuffy ' or ' mouth breather.' Its causes and
its influence locally and on the general health, its diagnosis and
treatment form a very large subject and can only be referred to
here to point out the importance of finding out the origin of the
obstruction and instituting immediate treatment.
"The French method of treatment known as diastolisation,
evolved by Professor Gautier and his staff some years ago at his
Paris clinic is one of the most successful modern methods of treatment
so far known for a very large number of cases of ' nasal
obstruction,' especially in children. This method has been widely
used for many years at the Walthamstow clinic. Generally the
results are very good, indeed, in many instances, quite remarkable.
Its curative effects are especially noticeable in cases of impaired
hearing in children where the hearing defect is due to certain
unhealthy conditions in the naso-pharynx, e.g., hypertrophic
rhinitis, etc.
"A speech-audiometer which shows accurately the extent of
the hearing loss for speech in either ear is always available at the
clinic for testing children referred with impaired hearing. As soon
as these children are seen at the clinic appointments are made for
them to have an audiometer hearing test. Then, after a course of
treatment, a further test is made and this will show what progress
has been made in recovery or otherwise. The audiometer is not
suitable for testing the hearing of children under seven years of
age.