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41
or in severe cases, a course of nasal treatment is carried out
before the Tonsil Suction is begun. This is all important,
for we must say emphatically that the removal of tonsils or
Suction, without the adequate treatment of co-existent sinus
disease is of no benefit. In fact, we have seen cases where
tonsils were removed in unhealthy, diseased sinus-nasal fields
which were left untreated and expected to be cured by the
tonsillectomy, but whose condition, on the contrary, was
aggravated and extended.
"Throughout the year Tonsil Suction has been used with
satisfactory results. A certain discretion has to be used in
the selection of suitable cases. There is a certain number,
but a small number of 'diseased tonsils' which is best treated
by operation. To go into the clinical details of this would
properly be the subject of a Clinical Paper rather than a general
Annual Report, but we can say that the greater majority of
school children can be treated and cured much more satisfactorily
and effectively by the combined methods (where
necessary) of Tonsil Suction and 'displacement', etc., than
by operation alone. It has many advantages over operation.
There is no operation risk, haemorrhage, etc., hospitalisation
or danger of secondary otitis media. The immunological value
of the tonsil tissue is retained and this is especially important
in young children. We stress here that mere hypertrophy of a
tonsil (unless it is so great as to become obstructive) is not in
itself, an indication for removal.
"There has been an increase in the amount of acute otitis
met with during the year, mostly arising from the mild epidemic
of measles and scarlet fever in the early part of the year, the
results of the early treatment of these cases has been most
satisfactory. Last year we referred to the regular employment
of suction in the treatment of acute otitis. It is a rational,
effective, rapid method of treatment. We use a Smith
(U. S. A.) Glass Suction Tube. The suction keeps the perforation
potent, allowing free drainage, empties the middle ear of the
irritating discharge and therefore considerably assists the
delicate tissues to recover and heal. If the discharge is
excessive or there is much pain, the suction is followed by a
long (one or two pints) warm douche of a mild antiseptic lotion
through a Fowler (U.S.A.) Suction cup. This is carried out
daily, and the majority of cases heal up rapidly.