EXTERNAL EAR, Diseases of.
Ec:c»ia of the auricle and meatus often exist together, and may be acute or chronic. Its treatment differs in no way from that of eczema in other regions. When the auricle alone is affected, in the acute stage, Zinc Ointment to which 3o mins. Liq. Plumbi F. to each ounce are added should be freely smeared over the affected skin, and lint also coated with the ointment should be applied. When the acute stage has passed, i dr. per oz. of Liq. Carbonis Deterg. with 20 grs. White Precipitate .3hould be added to the unguent.
In acute eczema of the meatus the best treatment will consist in filling the canal with .1.1mond Oil or Liquid Paraffin, mopping this out afterwards with wool, and instilling a few drops of i in 4o Liq. Plumbi F. In the chronic stage the meatus should be daily cleansed with warm Boric Acid solution, and after drying with wool a solution of io grs. Argent. Nit. in OZ. Spt. Ether. Nit. should be freely applied on wool twisted round a probe, after which a piece of lint or wool smeared with the ointment may be loosely packed into the external meatus.
Ilamatonta of the auricle, when small in extent, may be relieved by the local application of ice; when it is extensive it is best treated by a free incision, and dressing with a weak Spirit Lotion (r to 5) to which Per chloride of Mercury (I gr. tor oz.) is added.
Perichondritis should be relieved in the same manner, and after free incision under antiseptic precautions a warm Boric Acid poultice should he applied till pain disappears.
Evostoses, when blocking up the meatus, are best removed by gouging, by grinding down with a dentist's drill, by sawing with the ecraseur, or by inducing caries through the use of the trephine.
Diphtheria, and Hcrhetic Eruptions are treated upon the general principles indicated when these conditions affect other parts of the cutaneous covering; as erysipelas of the auricle and of the meatus is a common result of eczema and otorrhma, the primary condition must be carefully attended to; a r in 5 lchthyol solution is a good routine applica tion.
presence of small boils in the cartilaginous meatus causes intense pulsating pain and often an acute general inflammation of all the tissues entering into the external ear with mastoid swelling. When the patient consents the speediest method of treating them is to administer a general anesthetic, and with a sharp knife to make a deep incision into the inflamed spot without waiting for pointing of the abscess. The bleed ing should be encouraged by warm Boric fomentations and the meatus flushed with a i in i.coo Perchloride of Mercury solution.
Leeches to the auricle, followed by hot fomentations„ may be tried before incising, and Cocaine—the pure alkaloid dissolved in warm oil (4 per cent.) —affords some ease when dropped into the meatus; but to relieve acute pain in the ear, whether from the meatus or the tympanic membrane, the best application is a solution of so per cent. each Cocaine and Carbolic Acid in water. A very few drops poured into the ear out of an eggspoon (previously warmed) seldom fail to give relief. but as the pain in furun culosis is due to greatly increased tension in the unyielding structures constituting the meatus, relief of pain by any means short of incision is very disappointing. Stein uses 5 grs. of Resorcin and 25 grs. Cocaine in oz. water, and drops a little into the ear, where it is allowed to remain for a short time before being soaked out on wool. Smith cleanses the canal with alcohol, and applies tampons of Camphor-Phenol (carbolic acid 45, camphor 55 parts). A r in to solution of Menthol in liquid paraffin is also often serviceable.
The liability to recurrences is great, and by far the best local after treatment is the use of a Corrosive Sublimate solution to destroy the staphylococci which produce the furuncles. In the writer's opinion this solution is employed in too great dilution for this purpose. The following may be dropped into the ear once a day and the orifice plugged with cotton-wool Inoistened by the solution : B . Hydrargyri Perchloridi gr. ij.