Intrinsic Cancer of the Larynx and the Operation of Laryngo-Fissure, With a Description of some new Instruments specially designed for Improving the Technique
The Journal of Laryngology Rhinology and Otology
Second, the naked eye appearance of the antral wash, as to excess mucus, general turbidity, or flakes. Third, the bacteriological report. The exploration takes but a minute at the conclusion of the mastoid operation; but little time more is taken to make an opening through the middle meatus for subsequent lavage. Cases showing general turbidity, numerous flakes, and, in acute cases, thick pus, have been so treated, and, subsequently, washed out from time to time during the after-treatment of
... ter-treatment of the mastoid. All these have quickly cleared up. Where thick pus in quantity was found or polypoid degeneration of mucous membrane, and especially where the mastoid suggested nasal maintenance, a larger opening was made in the inferior meatus, through which subsequent treatment was carried out. Some of these cases still had a discharge from the maxillary antrum after the mastoid was healed. When the antral wash looked doubtful, or fairly clean, and the infection was latent-that is, only demonstrated by the bacteriological report -it has been found that the one treatment at the time of operation has, in many cases, been sufficient to cure. While if the mastoid cavity was at all slow in cleaning up, a few washes of the maxillary antrum through puncture under local anaesthesia, followed sometimes by injection of collosol argentum or one of the various silver salts, have proved sufficient. Similar observations on the maxillary sinus in cases of suppurative otitis media that have not come to operation show much the same results. These have not been included in this report, as all such eases have not been explored, owing to the difficulty of doing so in small children in the time at liberty to see them. But the cases that have been done are sufficient to convince me that it is desirable to do all, and that a routine exploration of the maxillary antrum in all cases of suppurative otitis media will discover many unsuspected infections. Is innocent of harm in itself, and, in fact, often appears to produce a beneficial effect even in those cases in which little evidence of maxillary antrum infection is revealed.