. Transactions. And always where we have for any reason removedsuch a growth, it is our duty to search most scrupulous-and repeatedly for evidence of perforation of the Shrap-nell meml)rane or minute fistula at some other point asthe source of discharge, however little the history maypoint to such a condition. DISCUSSION. Dr. Dkncii :—I should like to speak of two cases ofmalignant growth. The point the doctor brings out aboutthe presence of a l)ony tumor making one suspect a sup-purating ear is valual)le and we should remember thenecessity of operating on these cases to secure free drain-age.
. Transactions. And always where we have for any reason removedsuch a growth, it is our duty to search most scrupulous-and repeatedly for evidence of perforation of the Shrap-nell meml)rane or minute fistula at some other point asthe source of discharge, however little the history maypoint to such a condition. DISCUSSION. Dr. Dkncii :—I should like to speak of two cases ofmalignant growth. The point the doctor brings out aboutthe presence of a l)ony tumor making one suspect a sup-purating ear is valual)le and we should remember thenecessity of operating on these cases to secure free drain-age. Sometimes you cannot make a diagnosis of the con-dition behind until you have removed the obstacle infront. One of the cases of malignant growth I wish tospeak of was a libro-sarcoma, in a man sixty years oldwhere I thought at lirst there was a simple suppurative NEOPLASMS OF THE EAR. 461 M :*« ?^^^:^*;????/?^^- ?? ?;/• l?^--^^^ -^?.v - ?** V -?^ ?^•-^ - ^*iV<--\- .; -O^-sj;*. S 2 462 DISCUSSION. condition, or a polyp that had undergone fragment showed fibro-sarcomatous tissue, Thfe entiregrowth was examined after operation so that there wasno doubt as to the nature of its structure and yet recov-ery was good. Another case was that of an infant eight months old,who came into the Hospital on account of a dischargefrom the ear. The external canal was filled with a neo-plastic mass and there was a slight discharge from thecanal. I did a mastoid operation and found that the growthhad perforated the mastoid cortex. The dura was ex-posed for a considerable area. The growth was cu-retted out as thoroughly as possible and the woundhealed pretty well. The growth recurred and theultimate outcome was death. In the first place, whenthe child first came under observation the thing thatmade me suspect that it was a neoplasm was that thechild had a paralysis of the external rectus had come on early and persisted throughout theentire course of th
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