A text-book of the diseases of the ear for students and practitioners . in the mastoid process, accompanied bycaries and abscess-formation, develops with severe symptoms ofreaction, which are caused either by an obstruction to the out-flow of the septic contents of the abscess or by the impaction ofa sequestrum. The progressive destruction thus produced mayextend in different directions of the mastoid process and breakthrough the cortical layer. The part of the mastoid process which is most frequentlybroken through, is the external cortical layer. This usually takesplace with symptoms of sever
A text-book of the diseases of the ear for students and practitioners . in the mastoid process, accompanied bycaries and abscess-formation, develops with severe symptoms ofreaction, which are caused either by an obstruction to the out-flow of the septic contents of the abscess or by the impaction ofa sequestrum. The progressive destruction thus produced mayextend in different directions of the mastoid process and breakthrough the cortical layer. The part of the mastoid process which is most frequentlybroken through, is the external cortical layer. This usually takesplace with symptoms of severe congestion, and with the growthof a tumour over the mastoid and in its vicinity. The infiltra-tion, which is at first hard, shows a distinct fluctuation after thebreaking through of the cortical layer. If, in such cases, theabscess is not opened, the skin becomes perforated in one ormore places, after which the contents of the abscess are dis-charged, and the pain and fever diminish. Often the openingin the skin corresponds to the place where the cortical layer is. Fig. 259. SPONTANEOUS RUPTURE OF MASTOID ABSCESS 529
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