INFLAMMATION OF THE MASTOID' CELLS. (Acute or Chronic Mastoiditis)

Categories: Diseases of The Eye and Ear

This
disease represents one of the most serious terminations of an acute or a

chronic suppurative inflammation of the middle ear. This is fortunately a

comparatively rare event. There are, however, quite a good many cases of

this terrible disease.



Causes. It occurs as a primary or secondary disease. The first condition

is rare and the result from injury, exposure to cold and dampness, or from

syphil s or tuberculosis. Secondary disease is catarrhal or pus-like in

form. This results from an extension of middle ear disease through the

antrum, as a rule. The disease may develop at any time and endanger the

life of the sufferer.



Symptoms. Dull constant pain behind the ear and tenderness on pressure,

more severe at night, the tenderness is very apt to be followed in a short

time by redness and swelling of the skin in the same region. The pus may

drain from the mastoid into the middle ear cavity. If this does not happen

it may swell behind the ear and break through some other place. It may

involve the structures within the brain. If meningitis develops, the

patient has headache and later it becomes very severe. Lights hurts the

eyes, The patient is restless, sleepless, may have nausea and vomiting and

a constant high temperature. The neck is stiff and rigid. If there is more

brain involvement (phlebitis) there will be sudden rise of temperature,

followed by a rapid fall of temperature and attended by profuse sweating

and chills,--a dangerous condition. There can be abscess of the brain

also. In abscess of the brain symptoms are less severe and localized; the

rigid neck and fear of light and vomiting are absent.






Treatment. If seen early it may be aborted. If an examination of the drum

shows bulging, an incision of the drum head should be made. If an opening

is there it should be enlarged, if necessary. Cold applications are

valuable and should be applied directly over the mastoid behind the ear.

Sometimes hot applications are better, hot poultices, cloths, etc.,

syringing the canal with hot water. These applications, etc., should be

constantly used for a day or, so, unless unfavorable symptoms set in, when

if a marked improvement, especially in the local tenderness and pain, has

not occurred, an operation should be done and the mastoid opened.



The diet should be liquid (milk), nourishing and sustaining. Bowels should

be kept open.



This disease must be carefully watched. It is not only dangerous to life,

and very quickly, but it is full of disagreeable and dangerous

possibilities, lifelong discharge from the ear, an external fistulous

opening, a permanent paralysis of the facial nerve, abscess in the brain.

Brain symptoms, paralysis and pus symptoms do not now preclude an

operation on the mastoid for mastoid disease. The patient should be

closely watched and an operation performed as soon as called for.



I have given a longer description of the diseases of the ear than I

intended when I began this part of the work. Diseases of the ear are

becoming quite frequent, and the subject is important. I did not give much

general medical treatment because I consider the local treatment is of

more importance in a work of this kind. In treating the baby, I shall give

more medical treatment. I shall treat the disease also, especially in

relation to the baby. There can be more local applications used than those

given. If the hot treatment is thought best, not only hot water and

poultices of many kinds can be used, but fomentations of hops, etc., and

hot water cloths alone. The intent of such treatment is to keep hot moist

applications to the part continually. The use of laudanum in poultices

used for ear trouble is not recommended because its soothing power may

obscure symptoms that might appear and be dangerous in themselves and need

quick and thorough treatment. The syringing of hot water into the external

canal is often of great help. Five to ten grains of boric acid can be used

in an ounce of water. If there is much odor to the discharge, you can use

one part of carbolic acid to fifty parts of boiled water. The water should

not be used too hot. One teaspoonful of the acid to fifty teaspoonfuls of

water, or that proportion. After using the hot water, the canal should be

filled with gauze for protection and drainage. For the fever, the first

twenty-four hours, one-tenth to one drop of aconite can be used every one

to three hours. By putting one drop in ten teaspoonfuls of water you get

one-tenth of a drop at a dose.