Again, a single nasal passage may be blocked, which tends to a greater de velopment of the free nostril and a deviation of the partition toward the occluded side.
Of 1030 patients indiscriminately ex amined personally, only 100 had normal noses; that is to say, fairly vertical ,epta and symmetrical nasal cavities. The ages of the patients varied from one year to eighty. It was rare to find any obstruction, unless due to temporary causes, below ten years of age. The above statistics showed that nasal ob struction was seldom or never congen ital, was rare below ten years of age, and was more conmion after puberty. If from any cause—e.g., paralysis or paresis of the nasal dilators, injuries, inflammations of cartilage, enlarged in ferior turbinals, polypi, catarrh, etc.—one nostril becomes blocked up, the stream of air passing out of the one nasal cavity into the lungs exhausts the air in the closed nasal cavity, with the result that the walls of the nasal chambers become acted upon by a pressure exactly in pro portion to the degree of rarefaction. Hence we have varying degrees of septa! deviation and pinched and approximated upper maxillary bones, while upon the palate the effect is to produce high arching, with consequent irregular erup tion of teeth. Mayo Collier (Med. Press and Circ., Nov. 20, '95).
Treatment. —Fortunately, in a large majority of instances the patient con sults the rhinologist, not to have the ex ternal deformity corrected, because it is not sufficient to be a matter of much importance, but rather to have the ob struction to nasal respiration removed. It is again fortunate that usually the partition is so thickened that enough of the convex side can be removed to cure ample breathing space without per forating the septum, and without the necessity of the more severe operation of fracturing the nasal partition. Nearly every rhinologist has devised some strument for the removal of a portion of the nasal septum, or for its forcible replacement in the median line. The saw is probably used more than any other instrument, and it is especially applicable to cartilaginous deviations, which are the most common variety. Nasal saws have not, up to the present time, been made sufficiently strong so that bony deviations or enlargements can be easily excised with them. En larged antero-posterior sutural ridges which fill the inferior meatus are best removed with stout scissors or with a trephine. Small spurs can be reduced
by- a galvanocautery-puncture, and some times with chromic acid. Electrolysis is also recommended by various clinicians.
In treatment of septa] spurs and devi ations by electrolysis, preference should be given to steel needles as being more resistant and cheaper than platinum. They also penetrate more easily into the portions of cartilage which it is desired to destroy. The needles are combined with an electric battery of at least thirty couples, connected with an amperemeter, and an iminersion-rheostat. The nega tive pole is placed, according to the case, over the centre of the spur, and the posi tive pole outside or above this latter. An important point is not to put any needle too near the base of the devia tion, in order not to expose the septum to perforation. According to the volume and hardness of the growth to be de stroyed, the intensity of the current should vary from IS to 25 milliamperes, and last from twelve to fifteen minutes. When the needles are well placed. these intensities suffice for the destruction in a single sitting of a spur or septa! out growth in most cases.
During, electrolysis the opposite fossa ought to he watched through a specu hun—i.e., the undeviated septum— ii) order to make certain that no gas escapes from this side, which would in dicate that the electrolysis is carried be yond the point desired. :goitre (.1our. of Laryn., vol. viii, 230, '91).
Conclusions from 21 CIISC3 111 NV II id' electrolysis 1%:ts used as a trealluent for deviations, spurs, and ridges of the nasal septum: (a) The results aro favorable in most eases, but the method is neither so simple nor so sure as the usual sur gical means. (b) It should he limited lo those eases in which it is ifflpossihIc carry out surgieal treatment, cilhor account of the disinclination or dis ability of the patient. (c) Eleetrolysis requires an experienced spevialist to IIN It I. llt artilage yields wore - . I I than hone jel tl.iteotiiit is more •••,.‘ rt t .1 than normal bone. ( f) th. snail] size are success .. r dectrolysis. ty) l'er ....11 and s. oughing result from the +as i t. poo erful or too-prolonged cur r. et h • f, it to .27 millianipZ,res of cur r..-1.t 1%, re used for a time, varying from t h.., to twenty•seven minutes. NV. L. l'.111.•ng..r (Jour. Amer. Mcd. Assoc., ,i an. I I, '9(11.