A text-book of the diseases of the ear for students and practitioners . it is coveredwith the tissue of the membrana tympani; only when the in-flammation extends to its periosteum is a lacunar caries broughtabout, which eventually leads to absorption of the bone by theformation of granulation tissue and giant cells (Moos). In manycases examined histologically by the author, the partial osseous CARIES AND NECROSIS OF THE OSSICLES 489 defect, resulting from suppuration, was filled with new-formedconnective tissue.* As a rule, the inferior part of the handleis lost by the carious process; it is r
A text-book of the diseases of the ear for students and practitioners . it is coveredwith the tissue of the membrana tympani; only when the in-flammation extends to its periosteum is a lacunar caries broughtabout, which eventually leads to absorption of the bone by theformation of granulation tissue and giant cells (Moos). In manycases examined histologically by the author, the partial osseous CARIES AND NECROSIS OF THE OSSICLES 489 defect, resulting from suppuration, was filled with new-formedconnective tissue.* As a rule, the inferior part of the handleis lost by the carious process; it is rare to find the handleso completely affected that only the head and a part of the pro-cessus brevis remain. It is worthy of mention that the part of the incus mostfrequently destroyed is its long process ; this often occurs in thecourse of a simple suppuration of the middle ear which is notcomplicated with caries. In such cases there can be absolutelyno doubt that we are dealing with a simple absorption of thebone caused by the continuous action of the pus around the. Fig. 241.—Microscopic Section of the Carious Articulation of theMalleus and Incus in a Woman, Thirty-two Years Old, who diedfrom an Abscess in the Cerebellum, and who had suffered fromOtorrhcea since Childhood. a, Head of malleus ; &, Body of the incus ; c, Capsular ligament ; d, Cavity of thejoint opened by erosion of the capsular ligament; e e, Enlarged osseous spacesfilled with round cells. long process. It has already been mentioned that the loss ofthis process causes an interruption to the propagation of sound-waves to the labyrinth and a considerable disturbance of has been noticed that in post-mortem examinations the entireincus is sometimes wanting. In chronic middle-ear suppurationone not infrequently finds the head of the malleus and body ofthe incus ankylosed. The loss of the capitulum and crura of the stapes throughnecrosis has repeatedly been observed ; sometimes the necrosisof the stapes
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectear, booksubjecteardi
