A practical treatise on the diseases of the ear including the anatomy of the organ . lso reasoned that this increased tension would of itself ex-cite and maintain catarrhal inflammation of the tympaniccavity, especially if there was at the same time an affectionof the tube, and that it might cause a hinderance to the cir-culation in the labyrinth, with tinnitus aurium, etc. In short,Dr. Weber thought it possible that many varieties of non-suppurative affections of the middle ear might depend uponexcessive contraction of this muscle. The instrument which Dr. Weber uses for the operationis exact
A practical treatise on the diseases of the ear including the anatomy of the organ . lso reasoned that this increased tension would of itself ex-cite and maintain catarrhal inflammation of the tympaniccavity, especially if there was at the same time an affectionof the tube, and that it might cause a hinderance to the cir-culation in the labyrinth, with tinnitus aurium, etc. In short,Dr. Weber thought it possible that many varieties of non-suppurative affections of the middle ear might depend uponexcessive contraction of this muscle. The instrument which Dr. Weber uses for the operationis exactly figured in the accompanying engraving. A shortand thin hard rubber speculum is used so that there may beas much room as possible for manipulation. The head isfixed by a head-holder, to which an otoscope is attached; thehead may, however, be held by an assistant. The tenotomy is divided into four stages 1. The membrana tympani is perforated with the hook-shaped extremity of the tenotome, about 1—l^rnm. in front * L. c, Jahrgang IV., p. 143. 834 DIVISION OP TENSOR Webefs Knife for dividing the Tensor Tympani Muscle. of the handle of the malleus, somewhat below and to one sideof the short process. 2. The hook-shaped knife is pushed forward into the cavity DIVISION OF TENSOR TYMPANL 335 of the tympanum—the handle of the instrument being broughtdownwards and forwards—and thus it is made to grasp thetendon. (Just how the operator is to know when the hook isaround the tendon, I am unable to learn from Dr. Webersdescription. I suppose, however, from previous familiaritywith the operation on the cadaver.) 3. While the hook is about or over the tendon, the opera-tor exerts a gentle, drawing pressure upon it, by turning thehandle of the tenotome towards the face of the patient; thehook is then turned a third upon its axis, by means of thebutton which acts upon the cog, and the tendon is cut. Adistinct crackling sound is heard at the moment of the divi-sion of the te
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