A text-book of the diseases of the ear for students and practitioners . ge thatthe epidermic layer is raised in the form of blisters. As a rule,after the inflammatory process has run its course the maceratedepidermis is cast off and a rapid regeneration of the epithelialtissue takes place. In chronic inflammation of the membrana tympani an enor-mous thickening and growth of the epithelial layer very oftenoccurs ; this is especially the case when the membrane is affectedsecondarily to chronic otitis externa and chronic eczema, and afteran otitis media suppurativa has run its course (otitis desq
A text-book of the diseases of the ear for students and practitioners . ge thatthe epidermic layer is raised in the form of blisters. As a rule,after the inflammatory process has run its course the maceratedepidermis is cast off and a rapid regeneration of the epithelialtissue takes place. In chronic inflammation of the membrana tympani an enor-mous thickening and growth of the epithelial layer very oftenoccurs ; this is especially the case when the membrane is affectedsecondarily to chronic otitis externa and chronic eczema, and afteran otitis media suppurativa has run its course (otitis desquamativa,Buck). The detached epidermic masses consist of swollen andfatty epidermic cells, and of free fat globules and debris, in whichone very often finds cholesterine crystals and pigment. In a few cases, circumscribed hypertrophy and cornification ofthe epidermic layer take place, or, as in a case observed by theauthor, a pointed, horny growth formed which could not bedetached from the membrana tympani. In the course of chronic CHANGES IN THE MEMBRANA TYMPANI 227. inflammations of the middle ear, small, pearl-like nodules con-taining epithelial cells are sometimes formed on the membranatympani and in the external meatus (Urbantschitsch). Accordingto the authors observations, such conditions are by no meansrare after a suppuration of the middle earhas run its course. The author observed on the superior halfof the membrana tympani, in a case ofmiddle-ear suppuration which had run itscourse (Fig. 98), eight pearl-like protuber-ances of a bright lustre, which were thesize of a pins head. On probing they provedto be hard and firmly attached to the mem-brana tympani; after these nodules hadburst, their contents were examined, andfound to contain cholesterine crystals andfine-celled detritus. Grunert observed theformation of a cholesteatoma, the size of apins head, in a cicatrix following a para-centesis. Kiipper saw, in a phthisicalpatient, a cholesteatoma 1*5 mm. in sizesituated
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