. Diseases of the ear; a text-book for practitioners and students of medicine. is impossible to make a diagnosis uponrational symptoms alone, but objective examination at oncereveals the condition. Upon inspecting the parts, occlusionof the canal is at once evident, and the determination of theexact nature of the mass before removal is of no , however, should be given to one point in the ex-amination of these cases: it is the presence on the postero-superior wall of the canal of a mass consisting apparently ofcerumen, which extends along this aspect of the meatus in-ward ov
. Diseases of the ear; a text-book for practitioners and students of medicine. is impossible to make a diagnosis uponrational symptoms alone, but objective examination at oncereveals the condition. Upon inspecting the parts, occlusionof the canal is at once evident, and the determination of theexact nature of the mass before removal is of no , however, should be given to one point in the ex-amination of these cases: it is the presence on the postero-superior wall of the canal of a mass consisting apparently ofcerumen, which extends along this aspect of the meatus in-ward over the drum membrane, entirely or partially coveringit. This appearance is almost always indicative of a pre-ceding suppurative process within the tympanum, the foreignbody being really inspissated secretion, mixed with a certainamount of normal cerumen. Before removing this, the patientshould always be warned that the ear may discharge afterthe mass has been removed. The subsequent otorrhcea doesnot depend upon the removal of the mass, but upon a pre- 272 IMPACTED viously existing- intratympanic suppuration. If not warnedbeforehand the patient may scarcely understand this. Wherethe meatus is entirely occluded, and a view of the deeperparts is impossible, this condition may be present, and it is often wise for the surgeon toprotect himself even here, al-though it is not of as great im-portance as when the mass oc-cupies the situation above de-scribed. Prognosis.—The presence ofa mass of cerumen in the exter-nal auditory meatus does not ofitself constitute a menace to life,nor does it prevent a completerestoration of the auditory func-tion after the removal of the for-eign body. The serious conse-quences which occasionally fol-low the presence of these massesis due to secondary pathologi-cal changes which they excite,either by causing hypersemia and subsequently inflamma-tion, as the result of their pressure, or by setting up an in-flammatory process of desquamative
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Keywords: ., bookcentury1900, bookdecade1900, bookpublishernew, booksubjectear
