Handbook of diseases of the ear : for the use of students and practitioners / by Richard Lake.

Date:
1904
Catalogue details

Licence: In copyright

Credit: Handbook of diseases of the ear : for the use of students and practitioners / by Richard Lake. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    and carefully dried. If a general anccsthetic is used, the light may be carefully focussed on the ear before the patient is deeply unconscious, in order to avoid undue waste of time, and especially so if nitrous oxide is used. The only instrument required is a sharp-pointed myringotome. The drum is perforated posterior to the handle of the malleus, within a short distance of the posterior fold of the mem- brane. The inner tympanic wall should not be touched. The knife is then passed straight down to the inferior part of the membrane, dividing it in almost its whole length. The external meatus is then washed out with a 5 per cent, solution of carbolic acid, and a strip of sterilized gauze used to plug the canal. Division of the Tendon of the Tensor Tympani.— This operation may be performed under cocaine anaesthesia, but it is preferable to use a general anaesthetic. If cocame be chosen the aniline preparations must be employed, and strict antiseptic precautions are to be observed. An m- cision is made behind the handle of the malleus, com- mencing at the level of the short process, and extending down half the length of the handle. A tenotome is now introduced, either above or below the tendon, which is severed by a sawing movement of the knife. After the tenotome is removed a curved probe should be inserted in order to ascertain that the division is complete. Healing of the wound in the tympanic membrane will take place under antiseptic precautions in a few days, at the end of which time inflation should be employed in order to obtain improvement in hearing. The handle of the malleus tends to resume its normal position after this operation. In those cases in which the malleus is extremely retracted it may be necessary to divide the tendon through an interior incision, there not being sufficient space for a posterior incision. The hcemorrhage from this slight operation is rarely troublesome, and may be easily checked by plugging.