OPERATIONS FOR FURUNCULOSIS
The operative treatment consists in incising the furuncles and, if necessary, curetting out their contents.
Indications. (1) If, in spite of palliative treatment for two days, the pain be so intense as to prevent sleep, and be accompanied by pyrexia.
(2) If there be accompanying œdema of the auricle and surrounding parts.
(3) If the furuncles occur during the course of a middle-ear suppuration, and occlusion of the external meatus prevents free drainage of the purulent secretion.
When possible, it is always preferable to operate under a general anæsthetic, such as gas and oxygen. If, however, the patient objects to a general anæsthetic, it should be explained that, in spite of the application of anodynes, the operation, although of momentary duration, will be excessively painful.
Operation. After the ear has been thoroughly cleansed, a large aural speculum is inserted within the meatus and the auditory canal dried with pledgets of cotton-wool.
The instrument usually used for this operation is a small and narrow sharp-pointed knife known as Hartmann’s furunculotome (Fig. 178, C). Equally suitable, however, is a fine bistoury; or, if necessary, a small tenotome or the ordinary paracentesis knife.
