If a middle-ear catarrh with secretion of fluid occurs, owing to the tympanic membrane having been injured, it may be impossible to continue the gauze packing. In these cases only a fine drain of gauze should be inserted into the meatus, the dressing being changed as frequently as may be necessary.
Provided asepsis is maintained, the middle-ear inflammation usually subsides rapidly with healing of the membrane. After healing has taken place, inflation of the middle ear is recommended twice a week, for two or three weeks, in order to aid recovery and to prevent adhesions forming within the tympanic cavity.
Dangers. 1. If the exostoses be deeply situated, the tympanic membrane may be injured.
2. If much of the anterior wall of the auditory canal be removed, the temporo-maxillary joint may be opened.
3. It is possible that the tympanic membrane may not be recognized, and, by working too deeply, the labyrinth or the facial nerve may be injured.
Prognosis. Provided no accident has occurred during the operation, a successful result should be obtained. Stenosis, however, may occur from cicatricial contraction if the operation has been incompletely performed.
REMOVAL OF FOREIGN BODIES
Before considering the question of removal of foreign bodies, the following points cannot be emphasized too forcibly:—(1) No attempt should be made to remove a foreign body until it is certain that one really exists. (2) Provided there is no middle-ear suppuration, a foreign body left in the ear will very rarely cause any immediate harm. (3) The most serious complications are due almost invariably to ill-advised haphazard attempts to remove the foreign body; as a rule from working blindly in the dark without making use of reflected light.
If a foreign body be suspected, the surgeon should first carefully examine the auditory canal in order to determine its character and position and the condition of its walls. On this will depend the treatment to be employed.