Archives of Otology (Volume 32) (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: THE TREATMENT OF ACUTE OTITIS MEDIA. By Professor BEZOLD, Munich. Translated by Dr. Arnold Knapp. AS the acute inflammatory processes of the middle ear are variously classified in the different text-books, it seems proper to first give an exact definition of the morbid processes with which we have to deal. Most authors distinguish three principal groups: Acute middle-ear catarrh; The simple acute inflammation of the middle ear, otitis media acuta simplex, also called tympanitis acuta simplex; The acute purulent otitis media or acute purulent tympanitis. The subdivisions into croupous and diphtheritic otitis media, myringo-tympanitis, and acute desquamative otitis can be disregarded. A sharp distinction between these three main groups cannot be made either from an etiological or from a pathological standpoint. They are, in other words, different grades of the same morbid process. The character of the secretion formed in the middle ear serves as a useful criterion to separate a catarrhal from the more truly inflammatory type. The fluid in the former is serous, while in the latter it is sero-purulent or muco- purulent. The two varieties of the more inflammatory type, the simplex and the purulenta, differ only in degree. A distinct clinical picture is presented by that disease of the middle ear which depends upon simple occlusion of the Eustachian tube, whether the occlusion be acute or ofsome standing. This tubal catarrh is sharply defined by its pathognomonic otoscopic picture, and by the immediate return of the hearing after removal of the tubal occlusion. The secretion, at first serous then later more viscid though transparent, may be regarded as a transudate ex vacuo. The separation of this clinical picture from the other inflammatory processes was...