A text-book of the diseases of the ear for students and practitioners . lated acute exuda-tion in the external attic, which is onthe whole a rare form of disease, may beproduced by the same causes as otitismedia acuta. The author has repeatedlyobserved it during an attack of influenza(Kosegarten). It develops most fre-quently, however, during acute naso-pharyngeal catarrhs and in the acuteexanthemata. Knapp, who saw its occurrence aftersea-baths, states that infection may alsotake place from the external auditorycanal; this view is also corroboratedby Walb. According to the former, thebacteria
A text-book of the diseases of the ear for students and practitioners . lated acute exuda-tion in the external attic, which is onthe whole a rare form of disease, may beproduced by the same causes as otitismedia acuta. The author has repeatedlyobserved it during an attack of influenza(Kosegarten). It develops most fre-quently, however, during acute naso-pharyngeal catarrhs and in the acuteexanthemata. Knapp, who saw its occurrence aftersea-baths, states that infection may alsotake place from the external auditorycanal; this view is also corroboratedby Walb. According to the former, thebacteria may reach Prussaks spacethrough the inconstant Piivinian fora-men, or a primary inflammation of thewall of the meatus may extend to themargo tympanicus, and from here tothe external attic. According to theauthors observations, however, infec-tion takes place in the majority of casesthrough the Eustachian tube. These isolated inflammations ofthe external attic are analogous to those cases of abscess forma-tion in the mastoid process in which there are no inflammatory. Fig. 154.—Frontal Sectionthrough the hammer andExternal Attic of theLeft Ear, in a Woman,aged 91, who had puru-LENT Middle-ear Inflam-mation DURING THE LAST Days of her Life. h, Hammer ; a, External attic ;p, Processus brevis mallei; m,Manubrium mallei; s, Mem-brana Shrapnelli; e, e, Plaquesof exudate in tbe externalattic; e, Exudate in Prussaksspace. (From a preparationin the authors collection.) ACUTE INFLAMMATION OF THE EXTERNAL ATTIC 351 phenomena in the tympanic cavity, and in which the bacteriawithout doubt entered through the Eustachian tube. Conditions of the Membrana Tympani. — These varyaccording to the intensity of the inflammatory process andaccording to its different stages. In the milder forms, thesuperior pole of the membrane, the region of the short processof the malleus, and the bordering part of the upper wall of themeatus are intensely reddened and slightly swollen, while theinferior part of
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