INFLAMMATION OF THE MASTOID' CELLS. (Acute or Chronic Mastoiditis)
Categories: Diseases of The Eye and Ear
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
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.