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104
medical inspections. Usually by the time a child's deafness is noticeable to
the parent or teacher and is brought to the notice of the medical officer it
will be found by audiometric and clinical tests that at this stage the hearing
loss is well advanced and the prospect of full recovery much less certain.
This is particularly so when only one ear is affected as the loss here is
m asked by the normal hearing in the other ear and may not be noticeable to the
parents. The audiometer is especially useful in these cases and a school
audiometric survey is the most certain method of detecting any such likely
unnoticed deafness. In relation to deafness in children it is well to note
here that sinus disease, often overlooked, can be a very potent factor in
causing serious deafness and until the sinus infection is cleared up there
will not be any improvement in the hearing. The last audiometric survey in
the schools in Tottenham and Hornsey has been reported in the Annual Report
to the Committee for 1951.
Nasal Obstructions. A number of children have been seen at the clinics
suffering from nasal obstruction and its wide-spread effects, e.g mouthbreathing,
sore throats, chest affections, nasal sinus disease, neuroses, etc.
Nasal obstruction is, clinically, a very big subject in itself and can only be
referred to briefly. But it is perhaps the most important defect we see
because of the many and serious consequences which it produces. A very large
number of children suffering from certain forms of nasal obstruction have been
successfully treated at the clinics by Professor Gautier's (French) method of
'diastolization'. Diastolization, when the author's technique is carefully
carried out, ranks as one of the most successful advances in nasal therapeutics
in the last 25 years. It is particularly effective in certain forms of nasal
obstruction, such as hypertrophic rhinitis, and in deafness in children due to
lesions in the naso-pharynx. For many years this has been a standard method
of treatment at our clinics and the results in suitable cases have been
exceptionally good and lasting.
Sinus Infection. This is quite common among children of all ages.
Its recognition is vitally important because it is the primary source of many
other affections, and any treatment for these secondary effects, not directed
to the primary sinus disease, is misdirected therapy and will end in failure.
For the confirmation of the diagnosis and for the treatment of children with
sinus disease, Professor Proetz' method of 'sinus displacement' has been
extensively employed; but it is necessary to emphasise that the technique
devised by Proetz must be correctly used; indeed, if mi sapplied it can have
very serious consequences.
Among the very large number of children who have been treated by
'displacement' very few have been found who did not respond successfuly to
this method. Exceptions were the very chronic cases where the sinuses were
seriously affected by profuse purulent suppuration of long standing.
cases required operative treatment and were referred to hospital.