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69
Ear, Nose and Throat Clinics
Mr. F.P.M. Clarke, Consultant Ear, Nose and Throat Surgeon to the Hornsey E.N.T.
Clinic, reports: -
"The work of the ear, nose and throat clinic has been carried on during the year
1963 along similar lines to those of previous years. Average attendances have been
good and the majority of the patients seen were those with abnormal and unhealthy
conditions of the nose and its normal functions, its various spaces and sinuses;
rhinitis, sinusitis,"allergy", occasionally structural deformities, nasal obstruction,
mouth breathing, epistaxis, etc. These nasal abnormalities are primary and usually
the focal point from which many serious secondary defects develop later in related
regions - the eyes, ears, throat, lungs, etc.
A number of children have been referred with hearing defects, including those of
a suitable age for audiometric testing who have "failed" to past the test, and younger
children whose hearing can be tested only by clinical methods. Also a small number
with otitis media, acute or sub-acute, with or without discharge, and others with
external otitis. Some were seen who had one or more attacks of mild tonsillitis or
hypertrophied cervical glands, as well as some with speech defects queried as to any
relation with abnormal nasal function or defective hearing.
Longstanding chronic ear discharge has shown a marked decline in recent years.
After years of treatment elsewhere which had apparently failed, these cases respond to
the special method of zinc ionisation treatment, adopted at this clinic for many years
Methods of treatment so successfully employed include aural suction for acute
and sub-acute otorrhoeawith Chloromycetin mainly; zinc ionisation for chronic otorrhoea,
always with concurrent correction of any nasal factors causing or complicating the
condition.
For sinusitis, except acute, in children, Proetz "displacement method" using,
after initial weak ephedrine solution, albucid, or argyrol or lipiodol (French) as
indicated. The results, in selected cases, after lipiodol therapeutically, have been
very good. In certain cases of rhinitis, a course of Dowling's nasal argyrol packs.
Gautier's nasal diastolisation is perhaps the most frequently employed and is an
excellent method of treatment in suitable cases, with lasting results in clearing the
nasal passages and re-establishing a free nasal airway and normal respiration as well
as relieving the objectionable mouth breathing enforced by nasal obstruction. Also
in those frequent instances of defective hearing in young children, chiefly due to
unnoticed, untreated or incorrectly treated otitis, or nasal complications; defective
hearing is a very common sequel in nasal obstruction. Diastolisation in the majority
of cases through its effect in clearing the nasal respiratory airway, etc. has produced
the most remarkable results in the restoration of the affected hearing. Even in
deafness of long standing, due no doubt to the absence of suitable treatment, where
full normal restoration is not now possible, diastolisation can, properly used,produce
a very marked improvement. Its good results have been long established by such
authorities as A.G, Wells and A R„ Friel in this country, and numerous leading
specialists in France who first devised the method and technique and have practised it
extensively.
We have found nasal zinc ionisation very effective in rapidly and completely
suppressing the distressing symptoms in the few cases of allergic rhinitis treated.
The method was first devised by Leduc in France, and later used frequently and
successfully here by Friel and others.