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Ear, Nose and Throat Clinics.
In his comprehensive report, Dr. F.P.M. Clarke, the visiting consultant at the
Hornsey clinic, remarks that, although there has been a very good average attendance
of patients, both at his weekly E.N.T. sessions and the bi-weekly treatment clinics,
yet there has been a marked decline in the number of children found with discharging
ears. In the treatment of tonsils and adenoids, Dr. Clarke feels these glands should
be conserved as far as possible since they form an important protective ring of
lymphatic tissue surrounding the entrance to the chest and alimentary tract. He
considers that, in the majority of cases, enlarged and infected tonsils and adenoids
are the effect of a diseased condition elsewhere, such as sinusitis, and that,
therefore, the correct procedure is to seek and treat the cause rather than to remove
the effect.
Dr. Clarke found that the majority of children attending his clinic suffered from
nasal defects, particularly from nasal obstruction. He stresses the need for adequate
treatment of this condition if such ills as mouth-breathing, hearing loss, enlarged
tonsils and adenoids, sinusitis and chest infections are to be avoided. He points
out that the majority of cases readily respond to such procedures as nasal diastolisation
and vibration or to colloidal silver packs, without recourse to surgery.
Reviewing his fortnightly visits to the Park Lane Clinic, Tottenham, Mr. William
McKenzie, F.R.C.S., the Aural Surgeon, comments on how little is necessary or him to
do compared with even five years ago, and he feels that the improvement in children s
health is more striking in his specialty than in any other. He instances the fact
that the chronic discharging ear has nearly completely disappeared and that he seldom
sees a child who needs urgent tonsillectomy. That the general standard is so high,
Mr. McKenzie attributes to the better housing and the prosperity of the families in
the borough.
Audiology Unit
The team at the Audiology Unit remained in charge throughout 1961 and the table
below bears witness to a year of steady expansion. Nevertheless, despite a full
number of appointments per session, so that an additional 89 children were seen during
the year compared with the previous twelve months, it was still not possible to keep
pace with the list of children waiting to be examined. To remedy this, plans were
well advanced by the end of the year for the introduction of a second weekly session
for, as Dr. Fisch, the consultant otologist, states in his report, no child should
wait longer than two weeks for examination of his hearing.
Dr. Fisch points out that some of the equipment is still not installed; an
unwelcome delay, since without this apparatus it is not possible to carry out speech
audiometry. This, in turn, would permit more exact evaluation of the efficacy of a
hearing aid in certain cases, andwould allow observations to be made on the usefulness
of amplified speech in varying types of hearing loss.
As a natural outcome of an expanding unit, an additional burden has fallen on all
the members of the team, more especially upon the audiometrician and the peripatetic
teacher of the deaf. As the year closed, steps were to be taken for a second
audiometrician to be added to the establishment; and Dr. Fisch stresses the need for
another peripatetic teacher, whose work must be considered as one of the more important
factors in the care of the child with impaired hearing.