Report of two cases in which ligature was applied to the posterior auris artery
The Dublin Quarterly Journal of Medical Science
Ma. W. COLLES on Ligature of the Posterior Auris Artery. 73 ART. III.--Report of Two Cases in which Ligaturewas applied to the Posterior Auris Artery. By WIL~IA~ COL~ES, Surgeon to Steevens' Hospital. THE following cases present little similarity in the symptoms or appearance of the disease for which the operation was performed; they were both benefited by the operation, but in neither was the cure as perfect as could have been wlshcd, for in neither was the disease a pure unmixed aneurism. I
... mixed aneurism. I think both cases present features of interest, and are examples of the partial success of an operation of which we have few, if any, records. Mrs. F., a stout, healthy-looking woman, aged 27, mother of three children, states, that five or six years ago her attention was first drawn to a spot behind the left ear as being the situation to which she refhrred a buzzing sound constantly annoying her whenever she laid the head in a recumbent position. She could discover no turnout at that time. The no-ise has gradually increased to the present extent, and about a year ago she first perceived, the turnout and. felt the pulsation, in it. About three years since she had pare and deafness m the car, but this was relieved by syringing. At present she can scarcely obtain any sleep in consequence of a loud ringing noise, synchronous with the pulsations of the heart, pervading the entire head, which is worse when she lies on the affected side. During the day, any motion of the head, especially stooping, is attended with a sense of weight and giddiness, so that she dreads making any exertion. She has always been nervous, and subject to palpitations of the heart. On examination, a tumour is perceived, situated in the centre of the ridge of bone behind the left ear, and pushing it fbrward. It is about the size of a small walnut, measures one inch and a quarter in length, and three-quarters of an inch in breath, smooth, and of the natural colour. On. ap.py ~1 in~ the fingers, a pulsation, with evident expansion, is fblt in all parts of it. On increasing the pressure, the tumour, which feels quite soft and fluctuating, yields till we have the sensation as 'if" the finger sank into a depression or hole in the bone, through which the tumour emptied itself. On removing the fin~er the tumour again rises. On applying the stethoscope a rema~-kably loud bruit de soufltet is heard, synchronous with the pulsation of the arteries ; the posterior aural artery feels enlarged, and goes directly to the tumour. By pressure on this vessel the turnout becomes flaccid, the bruit ceases, and both again return on removing the pressure.