DOCSLIB.ORG

Nonsuppurative Inflammations of the Middle Ear

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Nonsuppurative Inflammations of the Middle Ear Universisty Of Szeged Department of Otorhinolaryngology and Head-Neck Surgery Nonsuppurative inflammations of the middle ear János András Jarabin M.D. PhD. INFLAMMATION OF THE MIDDLE EAR The inflammatory diseases of the middle ear are important because of their frequency and their life-threatening complications due to the close relationship between the middle ear and the cranial cavity. ICD-10 CODES https://icd.who.int/browse10/2019/en#/H65-H75 ICD-10 CODES https://icd.who.int/browse10/2019/en#/H65-H75 TYPES OF OTITIS MEDIA • Nonsuppurative otitis media – Acute nonsuppurative otitis media • Acute tubotympanic catarrh • Acute serous otitis media • Otitic barotrauma – Chronic nonsuppurative otitis media • Chronic tubotympanal catarrh • Chronic serous otitis media • Suppurative otitis media – Acute suppurative otitis media – Chronic suppurative otitis media • Chronic tubotympanic suppurative otitis media (mesotympanal) • Chronic atticoantral suppurative otitis media (cholesteatoma) ACUTE TUBOTYMPANIC CATARRH = Eustachian tube catarrh Pathophysiology • The acute and temporary disorder of the Eustachian-tube’s function and the consequential decrease in middle-ear pressure. • The tympanic membrane is pressed towards the medial wall of the tympanic cavity (called „retracted tympanic membrane”) and therefore its vibration is damped. Background: the epipharyngeal ostium of the Eustachian tube is blocked by the edema of the mucosa, due to rhinitis, rhinosinusitis, adenoiditis. ACUTE TUBOTYMPANIC CATARRH = Eustachian tube catarrh ▪ Symptoms – Pressure/fullness sensation in the ear – Mild tinnitus – Hearing loss (conductive type) ▪ Diagnosis – Otoscopy – Tympanometry ▪ Therapy – Decongestant nasal sprays can ease swollen nasal passages • E.g. xylometazoline (Novorin 0,1%); oxymetazoline (Nasivin 0,5mg/ml); tramazoline (Rhinospray Plus 1,265 mg/ml; etc.) – Valsalvamaneuver – Politzer-insufflation – Eustachian tube catheterization ACUTE SEROUS OTITIS MEDIA = acute otitis media with effusion decreased middle-ear pressure (± bacteria or virus with reduced virulence; allergy…etc.) transsudation (straw yellow, low viscosity, odourless discharge) ACUTE SEROUS OTITIS MEDIA = acute otitis media with effusion ▪ Symptoms – Pressure/fullness sensation in the ear – Mild tinnitus – Hearing loss (conductive type) ▪ Diagnosis – Otoscopy – Tympanometry – Audiometry ▪ Therapy – Decongestant nasal sprays can ease swollen nasal passages • E.g. xylometazoline (Novorin 0,1%); oxymetazoline (Nasivin 0,5mg/ml); tramazoline (Rhinospray Plus 1,265 mg/ml; etc.) – Valsalvamaneuver – Politzer-insufflation – Eustachian tube catheterization ACUTE SEROUS OTITIS MEDIA otoscopoy „retracted” tympanic the short process of the air bubbles are often membrane malleus promine, its present in the fluid behind handle apparently the tympanic membrane shortened ACUTE SEROUS OTITIS MEDIA = acute otitis media with effusion * • Audiometry – conductive hearing loss BC: bone conduction AC: air conduction * ABG: air-bone gap ACUTE SEROUS OTITIS MEDIA = acute otitis media with effusion Tympanometry - typical: C, Cround and B type OTITIC BAROTRAUMA AEROOTITIS sudden, expressed pressure drop within the tympanic cavity (usually when the aircraft lands) ▪ Sudden onset: ▪ tympanic membrane tenion ▪ tympanic cavity mucosal edema ▪ transsudation ▪ possibly bleeding OTITIC BAROTRAUMA AEROOTITIS ▪ Symptoms – Severe pain in the ear – Pressure and fullness sensation in the ear – Hearing loss (conductive type) ▪ Diagnosis – Otoscopy – Tympanometry – Audiometry ▪ Therapy – Decongestant nasal sprays can ease swollen nasal passages (before takeoff and LANDING) – Valsalva-maneuver – Politzer-insufflation – Eustachian tube catheterization – Preventive myringotomy (paracentesis) in unconcious patients Chronic nonsuppurative otitis media Chonic tubotympanal catarrh Chronic serous otitis media Chronic mucoid otitis media Glue ear 6 weeks < CHRONIC TUBOTYMPANIC CATARRH Pathogenesis • Long-lasting occlusion of the Eustachian tube, and the consequential decrease in middle-ear pressure. • Edema of the mucosa, passive transsudation (straw yellow effusion) • Mucosal metaplasia – accumulation of goblet cells • Mixing of mucus with the transsudate - seromucosus exsudatum • Formation of cholesterol granulomas CHRONIC TUBOTYMPANIC CATARRH Pathogenesis: long-lasting Eustachian tube occlusion • Nasal airway obstruction – Adenoid vegetation – Nasal septum deviation • Maxillary sinusitis, ethmoiditis, pansinusitis) • Chronic rhinitis, allergic rhinitis • Developmental disorders: cleft palate, choanal atresia • Paralysis of the palatal muscles • Nasopharyngeal tumors (endoscopy, fiberoscopy!!!) CHRONIC TUBOTYMPANIC CATARRH Symptoms • Fullness and pressure sensation in the ear • Hearing loss (pure/dominantly conductive type) • Tinnitus CHRONIC TUBOTYMPANIC CATARRH Diagnosis • „Adenoid facies” • In the case of adenoid vegetation, the middle ear process must always be considered! CHRONIC TUBOTYMPANIC CATARRH Otoscopy „retracted” tympanic membrane the short process of the air bubbles are often malleus promine, its present in the fluid behind handle apparently the tympanic membrane shortened exsudatum accumulates within the tympanic cavity – the tympanic membrane is amber colour, sometimes dark discoloration is seen CHRONIC TUBOTYMPANIC CATARRH Diagnosis • Audiometry – conductive hearing loss CHRONIC TUBOTYMPANIC CATARRH Diagnosis • Impedance audiometry: – typical tympanogram (flat line: Cround and B) CHRONIC TUBOTYMPANIC CATARRH Therapy • Ethiological and predisposing factors must be eliminated: – adenotomy – sanation of sinusitis – etc. • Myringotomy/paracentesis – drainage of the middle ear CHRONIC TUBOTYMPANIC CATARRH Therapy CHRONIC TUBOTYMPANIC CATARRH Therapy CHRONIC TUBOTYMPANIC CATARRH Therapy • Myringotomy and drainage – anaesthesia, operating microscope – incision in the anterior-inferior quadrant – drainage – ventillation tube or grommet insertion CHRONIC TUBOTYMPANIC CATARRH Therapy • Myringotomy and drainage – anaesthesia, operating microscope – incision in the anterior-inferior quadrant – drainage – ventillation tube or grommet insertion CHRONIC TUBOTYMPANIC CATARRH Therapy CHRONIC TUBOTYMPANIC CATARRH Therapy • Myringotomy and drainage – anaesthesia, operating microscope – incision in the anterior-inferior quadrant – drainage – ventillation tube or grommet insertion CHRONIC TUBOTYMPANIC CATARRH Prognosis • Inadequate therapy – the exudate is organized; connective tissue remodeling occurs in the middle ear – adhesions are formed = adhesive otitis media – permanent hearing loss (conductive type) CHRONIC TUBOTYMPANIC CATARRH Prognosis • Inadequate therapy – atrophy of the tympanic membrane – retraction pocket formation – cholesteatoma (aquired) THANK YOU FOR YOUR ATTENTION!.
Load more

Recommended publications
  • SINUSITIS AS a CAUSE of TONSILLITIS. by BEDFORD RUSSELL, F.R.C.S., Surgeon-In-Charge, Throat Departmentt, St
    Postgrad Med J: first published as 10.1136/pgmj.9.89.80 on 1 March 1933. Downloaded from 80 POST-GRADUATE MEDICAL JOURNAL March, 1933 Plastic Surgery: A short course of lecture-demonstrations is being arranged, to be given at the Hammersmith Hospitar, by Sir Harold Gillies, Mr. MacIndoe and Mr. Kilner. Details will be circulated shortly. Technique of Operations: A series of demonstrations is being arranged. Details will be circulated shortly. Demonstrations in (Advanced) Medicine and Surgeryi A series of weekly demonstrations is being arranged. Details will be circulated shortly. A Guide Book, giving details of how to reach the various London Hospitals by tube, tram, or bus, can be obtained from the Fellowship. Price 6d. (Members and Associates, 3d.). SINUSITIS AS A CAUSE OF TONSILLITIS. BY BEDFORD RUSSELL, F.R.C.S., Surgeon-in-Charge, Throat Departmentt, St. Bart's Hospital. ALTHOUGH the existence of sinus-infection has long since been recognized, medical men whose work lies chiefly in the treatment of disease in the nose, throat and ear are frequently struck with the number of cases of sinusitis which have escaped recognition,copyright. even in the presence of symptoms and signs which should have given rise at least to suspicion of such disease. The explanation of the failure to recognize any but the most mlianifest cases of sinusitis lies, 1 think, in the extreme youth of this branch of medicine; for although operations upon the nose were undoubtedly performed thousands of years ago, it was not uintil the adoption of cocaine about forty years ago that it was even to examine the nasal cavities really critically.
    [Show full text]
  • Differentiated from the Rare Congenital Lues. Catarrhal Pharyngitis Produces Attacks of Hacking Cough with Frothy Mucus Appearing in the Mouth and on the Lips
    Sir,-Your editorial in the February Research Newsletter has asked for sug- gestions on the classification and elucidation of minor maladies seen in general practice. I would like to recall the catarrhal diathesis of the older physicians. Perhaps it should be called a catarrhal state. It is extremely common especially in under fives and over fifties. It is conceived as an imperfect state of health or an incomplete defence against infection. Indeed, saprophytic organisms are encouraged to become virulent and inflammatory in the milieu of catarrh. In the newly born it is manifested as a sticky eye and a nasal snuffle which must be differentiated from the rare congenital lues. Catarrhal pharyngitis produces attacks of hacking cough with frothy mucus appearing in the mouth and on the lips. Catarrhal gastritis causes anorexia and irregular vomiting of curdy milk, sour fluid and mucus. Catarrhal bronchitis requires no description except to state that in its non-toxic afebrile form it can be associated with bronchospasm or bronchial relaxation. Deeper still within the young baby is the manifestation of catarrh called infantile gastro-enteritis which is a disease of uncertain etiology. At about four or five the child with the catarrhal diathesis develops tonsillar and adenoidal hypertrophy and hyperaemia, catarrhal otitis media (no pus formation), sinusitis and more active bronchitis with fever and secondary infections. Between seven and ten seems to be the favourite age for short attacks of mucous colitis. I have also seen two cases which clinicallv resembled ulcerative colitis but were of short duration. Stool cultures were negative for any pathogens and the disease occurred in isolated instances when no dysentery was observed in the vicinity.
    [Show full text]
  • Allergic Rhinitis Adults and Adolescents 12 Years and Over Cambridgeshire and Peterborough Joint Pathway
    Allergic Rhinitis Adults and Adolescents 12 years and over Cambridgeshire and Peterborough Joint Pathway Diagnosis from symptoms (nasal congestion, rhinorrhoea, itching, sneezing) Allergen/irritant avoidance advice with/without douching. Encourage Self-Care. Full patient history and nasal examination is essential MILD SYMPTOMS MODERATE – SEVERE SYMPTOMS Encourage Self-Care Encourage Self-Care • No troublesome symptoms • Abnormal sleep, sleep disturbance • Completes normal daily symptoms • Impairment of daily activities, sport, leisure • Normal work and school • Troublesome symptoms • Normal sleep disturbance • Problems caused at work or school ORAL/INTRANASAL NON-SEDATING H1 INTRANASAL CORTICOSTEROID* ANTIHISTAMINE ‘as needed’ 1° Care Responsibility Treatment Failure** 2° Care Responsibility Encourage Self-Care* 2° Care advice to 1° Care Check use, concordance dose COMBINATION OF AN ‘AS-NEEDED’ ORAL/INTRANASAL ANTIHISTAMINE AND REGULAR INTRANASAL CORTICOSTEROID* Treatment Failure** Check use, concordance dose olicy Itch/sneeze/extra Catarrh: add Watery Blockage: add short nasal itch/rash: add Montelukast if Rhinorrhoea: -term intranasal non-sedating H1 asthmatic (review Add decongestant (5 – 7 oral antihistamine after 28 days for Ipratropium days’ maximum) regularly. effect) Routine GP Treatment follow up Failure** ENT/ surgical Allergy specialist Referral Inflammatory rhinitis Referral (Skin prick test or blood test to confirm allergy if appropriate) Course of oral Potential Consider combination preparation of intranasal corticosteroids,
    [Show full text]
  • Testing Prairie Plants with Ethnobotanical Importance for Anti·Cancer and Anti·Aids Compounds
    Journal of Ethnobiology 18(2):229-245 Winter 1998 TESTING PRAIRIE PLANTS WITH ETHNOBOTANICAL IMPORTANCE FOR ANTI·CANCER AND ANTI·AIDS COMPOUNDS KELLY KINDSCHER Kansas Biological Survey University ofKansas 2041 Constant Ave lAwrence, KS 66047-2906 KIRK I' MANFREDI MELISSA BRITTON MARIA DEMIDOVA Department ofChemistry University o/Northern Iowa Cedar Falls, IA 50614 AND DANA P. HURLBURT Department 0/ Systematics and Ecology University of Kansas lAwrence, KS 66045 ABSTRACT. - Literature research into ethnobotanical uses of North American prairie plants by Native Americans and early written accounts by travelers and doctors identified 203 native prairie species that have been used for medicine. We collected, identified, and made extracts from 22 of these species and subjected the extracts to biological screens to identify new anti-HIV and anti-eancer chemical leads. Our results show greater rates of activity for both aqueous extract anti­ AIDS screens (60.0%) and organic extract anti-AIDS screens (13.6%) than rates previously determined through random screening of terrestrial plants (13.9% and 3.0%, respectively). In preliminary anticancer screening, 10 of 22 organic extracts showed at least moderate activity. This work demonstrates that native prairie plants (and probably those of other regions in North America) may provide new chemical leads, especially if the target list includes those species that have ethnobotanical use histories. We also believe that our work helps substantiate the idea that Native Americans were choosing many plants with pharmacologically active substances in their health and healing practices. RESUMEN. - Una investigaci6n bibliografica acerca de los usos etnobotanicos de plantas de las praderas norteamericanas por parte de los indfgenas, y las descripciones tempranas de viajeros y medicos, idcntific6 203 especies nativas de la pradera que han sido usadas como medicinas.
    [Show full text]
  • The Tonsils and Nasopharyngeal Epidemics * by W
    Arch Dis Child: first published as 10.1136/adc.5.29.335 on 1 October 1930. Downloaded from THE TONSILS AND NASOPHARYNGEAL EPIDEMICS * BY W. H. BRADLEY, B.M., B.Ch. In a paper on nasopharyngeal epidemics presented to the Section of Epidemiology and State Medicine of the Royal Society of Medicine on 22nd June, 1928, J. A. Glover suggested an investigation into the 'relative incidence of droplet infections upon children whose tonsils have been enucleated and whose adenoids have been removed, compared with children who have not been operated on.' I have attempted this investigation, and by reference to a small part of the literature on the subject, to discuss my observations. The material observed is a public school for boys. A preparatory school is included, so that the ages of the boys under observation range from ten to eighteen years. The enquiry resolved itself into two parts Part 1. The condition of the throat in health. Part 2. The incidence of catarrhal disease. 1.-A sample of the school, 289 boys in good health, was examined during the second half of July, 1929, and data rSlative to the tonsil, the oral pharynx, the buccal mucosa and the cervical glands noted. The figures http://adc.bmj.com/ obtained are compared with the results found in Part 2. 2,-An analysis was made of my records of the acute, non-notifiable, upper air-passage infections occurring in the same boys during the four preceding school terms. A period of approximately one year of actual observation, but including two summer terms, is therefore dealt with.
    [Show full text]
  • The Ethnobotany of Sweet Flag, Acorus Calamus L
    Eastern Illinois University The Keep Masters Theses Student Theses & Publications 1989 The thnobE otany of Sweet Flag, Acorus calamus L. Timothy J. Motley Eastern Illinois University This research is a product of the graduate program in Botany at Eastern Illinois University. Find out more about the program. Recommended Citation Motley, Timothy J., "The thnoE botany of Sweet Flag, Acorus calamus L." (1989). Masters Theses. 2337. https://thekeep.eiu.edu/theses/2337 This is brought to you for free and open access by the Student Theses & Publications at The Keep. It has been accepted for inclusion in Masters Theses by an authorized administrator of The Keep. For more information, please contact [email protected]. THESIS REPRODUCTION CERTIFICATE TO: Graduate Degree Candidates who have written formal theses. SUBJECT: Permission to reproduce theses. The University Library is receiving a number of requests from other institutions asking permission to reproduce dissertations for inclusion in their library holdings. Although no copyright laws a _re involved, we feel that professional courtesy demands that permission be obtained from the author before we allow theses to be copied. Please sign one of the following statements: Booth Library of Eastern Illinois University has my permission to lend my thesis to a reputable college or university for the purpose of copying it for inclusion in that institution• s library or research holdings. , /'7 / Date Author I respectfully request Booth Library of Eastern Illinois University not allow my thesis be reproduced because -------------- Date Author m THE ETHNOBOTANY OF SWEET FLAG ACORUS CALAMUS L. (TITLE) BY Timothy J . Motley THESIS SUBMITIED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF Master of Science IN THE GRADUATE SCHOOL, EASTERN ILLINOIS UNIVERSITY CHARLESTON, ILLINOIS 1989 YEAR I HEREBY RECOMMEND THIS THESIS BE ACCEPTED AS FULFILLING THIS PART OF THE GRADUATE DEGREE CITED ABOVE s 11'.:J /'n DATE ADVISER DATE ~EPARTMENT HEAD THE ETHNOBOTANY OF SWEET FLAG, ACORUS CALAMUS L.
    [Show full text]
  • Allergic Rhinitis - Definition of Allergic Rhinitis by Medical Dictionary
    Allergic Rhinitis - definition of Allergic Rhinitis by Medical dictionary forum List Mailing Day the of Word the Join webmasters For Dictionary, Ency Ency Dictionary, T E X T TheFreeDictionary Google Bing E-mail ? Password 60% Word / Article Starts with Ends with Text Remember Me 6,919,959,783 visitors served. Register Forgot password? Dictionary/ Medical Legal Financial Acronyms Idioms Encyclopedia Wikipedia ? thesaurus dictionary dictionary dictionary encyclopedia Allergic Rhinitis Also found in: Dictionary/thesaurus, Acronyms, Encyclopedia, Wikipedia 0.02 sec. Page tools ? Sponsored links Like 1 Share: Cite / link: Allergic Rhinitis | Printer friendly Feedback Nasal-Allergies.com Cite / link Add definition Find Info on Nasal Allergic Rhinitis Allergies and a Non- This site: Drowsy Treatment Definition Option. Allergic rhinitis, more commonly referred to as hay fever, is an inflammation of the nasal passages caused by Like 334k www.Nasal-Allergies.com allergic reaction to airborne substances. on h Wr o te a MiigList Mailing Day the of Word the Join Follow: Share: More Sponsors: allergies, Description allergy medication, Allergic rhinitis (AR) is the most common allergic condition and one of the most common of all minor seasonal allergies, afflictions. It affects between 10-20% of all people in the United States, and is responsible for 2.5% of all allergy relief, allergy doctor visits. Antihistamines and other drugs used to treat allergic rhinitis make up a significant fraction of asthma both prescription and over-the-counter drug sales each year. On this page There are two types of allergic rhinitis: seasonal and perennial. Seasonal AR occurs in the spring, summer, Word Browser and early fall, when airborne plant pollens are at their highest levels.
    [Show full text]
  • The Catarrhal State
    THE CATARRHAL STATE P. D. MULKERN, M.R.C.S., L.R.C.P. Romford It was during the measles epidemic of the autumn of 1951 to the spring of 1952 that I blundered-for there is no other more suitable word to describe my shameful and unscientific empiricism-on a useful treatment to control the catarrhal state. Frequent upper respiratory tract infections, otorrhoea, sinusitis and tonsillitis became the accepted accompaniment of convalescence from measles in this working-class practice. Quite a number of adults were known to have quiescent tuberculosis and I was anxious that children debilitated by measles should not inadvertently become infected by neighbours as they played in other houses. So it became a routine to use the jelly test for tuberculin sensitivity during the 6 months after recovery in any children who appeared to be unduly debilitated, prone to frequent colds and catarrh, or who suffered multiple attacks of upper respiratory tract infection of one kind or another. I found quite a number of positive reactors, although on looking round I could never trace the source. Nor could I detect any physical signs of a primary focus by clinical or radiological examinations. Nevertheless, I decided to try the effect of rimifon on these children who were underweight, full of catarrh, wouldn't eat, had no energy and who were also positive reactors to thejelly test. To my surprise and delight they appeared to make very satisfactory progress and their mothers would come again and again for the " vitamin tablets ". As long as the treatment continued the catarrh was controlled, nocturnal nasal obstruction disappeared and there were no further infections of the throat or ears.
    [Show full text]
  • Wellness Rx Program for Managing Chronic Sinusitis”
    WELCOME to the “Wellness Rx Program for Managing Chronic Sinusitis” I am especially delighted to present this program to you for a very personal reason – I have been a lifelong sinusitis sufferer and have been through the rounds of drugs and surgery. Nothing helped for very long and often didn't help at all. You may have had the same disappointment. I finally tried a more holistic approach. I stopped buffeting my system with medications and started looking at the factors in my life such as environment, diet and lifestyle that could be contributing to my condition. I began to keep a careful record of what I ate, the weather patterns and even if there was a new carpet smell in the office. I added to the list as new things occurred to me. Before long, patterns began to emerge. I began to identify the triggers to my sinus attacks that I could avoid. At the same time, I sought for more information, ​ began using a saline douche daily, worked hard to stay hydrated, increased my daily intake of strong immune boosters with antiviral properties (i.e. Elderberry tonic & Mushrooms Extract Tinctures) and understood how to use other intervention products and techniques like colloidal silver, essential oils, acupuncture and acupressure. I put everything I had learned together-and, it worked! I found I could control my sinusitis with prevention and a holistic approach, not with the usual battery of medications. I discovered that my condition was a result of a combination of factors that involved my mind, body and even my spirit.
    [Show full text]
  • Serous Otitis Media Otitis Media
    Serous otitis media Otitis media WILLIAM H. LUM, D.O., F.O.C.O. Providence, Rhode Island Serous otitis media is a major cause The term "serous otitis media" describes a of permanent conductive deafness. The condition for which there is an unusually large otologist, pediatrician, and general number of alternate terms, more or less de- scriptive and synonymous : "exudative middle practitioner should have a high level of ear catarrh," "secretory otitis media," "hydro- suspicion when confronted with the tympanum," "middle ear effusions," "acute fluid-filled ear in order that adequate non-suppurative otitis media," "acute salpin- treatment can be initiated promptly. gitis," "tubotympanitis," "otosalpingitis," "tu- The disease can be insidious in onset bal catarrh," "otitis media with effusion," and difficult to diagnose, but its early "catarrh of the middle ear," "hydrops ex vacuo," and "otitis media exudativa." recognition is essential since resistance Serous otitis media can be defined as an to treatment increases with the affliction of the eustachian tube and middle duration of the condition. The ear, with the accumulation of non-purulent pathogenetic mechanism of serous fluid in the middle ear which adversely affects otitis media is unknown but it is the hearing and/or comfort of the patient. believed that an obstruction of the Historically this is not by any means a new clinical entity, Politzer having first described eustachian tube prevents proper its symptoms and treatment in 1862. The litera- drainage and ventilation of the middle ture on the subject was rather sparse until the ear. The fluid is the result of disease, early 1940s, but since the 1950s many articles rather than a disease itself, and the have appeared.
    [Show full text]
  • Nasal Catarrh
    NASAL CATARRH. With Compliments of THOS. GILBERT, PRINTER AND STATIONER, COLUMBUS, GA. To the Reader. It is with great pleasure that we we present you with a copy of this pamphlet, and we beg to say that the motive which prompt it is to show you, in as plain a manner as possible, your condition, should you now have Nasal Catarrh in any of its forms, and designate to yon its successful termination. Should I save a young and promising life, stay the hand bent upon self destruction in the aged, or deprive the grave or the insane asylum of its expected prey, then the writer will feel repaid for time and money spent in your interest. 1418 Fourth Avenue, July, 1892. Kasai Catarrh. There are several varieties of this dreaded disease, viz.: Hypertrophic Catarrh, Atrophic Catarrh, Ulcerative Catarrh, Syphilitic Catarrh, Catarrh from various growths; Polypus, Popilomata, Enchaudrama, etc., etc. HYPERTROPHIC CATARRH. Hypertrophic Catarrh is divided into an acute and a chronic stage. Acute Catarrh generally is caused from exposure, cold, and is nothing more than “acold in the head,” ora “bad cold.” It is, however, brought about at times from other causes, viz.: impure air—that is, air contaminated with foreign bodies, such as dust, smoke, tobacco, and in persons who have an idio- syncrasy, the polen of certain plants will bring on an attack. Oftentimes, with a little hygienic care, with removal of the cause, in a week or ten days the mucus membrane will resume its normal functions and a cure is complete. At other times, however, when one is not so prudent, and possibly has an hereditary predisposition to relax throat, weak lungs, bronchial trouble, consumption, etc., Acute Catarrh does not behave so luckily, but like Banquo’s ghost, still lingers and will not down, and a fresh cold is contracted, and after each fresh attack the nasal mucus membrane becomes more inflamed, and over the turbinated bones a hypertrophy (fig.
    [Show full text]
  • Sinusitis in Childhood
    Arch Dis Child: first published as 10.1136/adc.7.41.277 on 1 October 1932. Downloaded from SINUSITIS IN CHILDHOOD BY VALENTINA P. WASSON, L.R.C.P., M.R.C.S. (From the Out-Patient Department, The Hospital for Sick Children, Great Ormond Street, London.) Sinusitis as a common source of ill-health in children has received but little attention in English medical publications: in American, Canadian and Australian journals articles on this subject have been frequent, its importance being fully recognized by physicians dealing with children. Though in the United States many varieties of common naso-respiratory complaints in children, formerly persistent and troublesome, are now being successfully treated as manifestations of sinusitis, in England these equally common complaints, such as ' winter coughs,' ' wheezy chests ' and ' running noses,' are still widely accepted as chronic nasal catarrh and bronchitis. Sinusitis indeed is frequently regarded as a typical American disease, occurring seldom in Great Britain, and attributable to the inclement weather of the United States and the dry over-heated air of American dwellings. That this attitude is unwarranted, sinusitis being a common affection among English children and living conditions only in a minor degree responsible for the disease, is the theme of this article. http://adc.bmj.com/ In 1913, McKenzie1 reported three cases of chronic sinusitis in children successfully treated by operation, and in the following year Tilley" reported three other cases, giving details of the procedure. Watson-Willianis: in 1921 wrote on the clinical import of familial infection of chronic sinusitis, dealing with the ' carrier infectivity ' of one or more members of the same family.
    [Show full text]