Other methods of removal. These are not recommended, but merely mentioned for the sake of completeness.
By forceps. The rough and ready method of extracting a polypus forcibly from the ear by means of forceps, although practised formerly, has now been discarded as being unsurgical and dangerous.
Ligation. The operation consisted in passing a snare over the polypus and grasping it tightly as near to its base as possible. The snare was then twisted round its axis in order to tighten the loop further and so obliterate the blood-supply of the growth, the wire of the snare being afterwards cut through with pliers and the snare withdrawn. After a few days the polypus became gangrenous from want of blood-supply, and separated from its deep attachments.
Curetting. This method, which should only be made use of in the case of small multiple polypi within the tympanic cavity, will be considered when discussing the treatment of granulations within the middle ear (see [p. 398]).
Dangers. Hæmorrhage is seldom profuse, but if it is, it can always be arrested by packing the meatus with cocaine and adrenalin solution.
The chief dangers are injury to the contents of the tympanic cavity, such as dislocation or removal of the ossicles; or subsequent meningitis. These mishaps are usually the result of forcible extraction, or of blindly curetting the ear after this has been done. Meningitis, however, has been known to occur, in spite of every precaution being taken, if, owing to caries of the tegmen tympani, the polypus has its origin from the dura mater of the middle fossa.
Prognosis. If the polypus be single and of recent origin, the result probably of acute inflammation of the middle ear, its removal may cause complete recovery and cessation of the middle-ear suppuration.
In the case, however, of multiple polypi associated with chronic middle-ear suppuration and usually signifying underlying bone disease, recurrences may be frequent and further operations may become necessary.
It may here be emphasized that a polypus in itself is not a disease, but merely a symptom of disease.