Results. Provided that the granulations are localized and due to inflammation of the mucous membrane, a good result may be anticipated. If, however, there be underlying bone disease of the tympanic walls, or if the mastoid process be already affected, recurrences are usual, and further operative treatment may become necessary.
OPERATIONS UPON THE OSSICLES
DIRECT MOBILIZATION OF THE OSSICLES
The object of the operation is to improve the hearing by breaking down the fibrous adhesions with the tympanic cavity, which diminish the mobility of the ossicles.
Direct massage of the malleus. Indications. (i) As a therapeutic measure. If the malleus be adherent to the promontory and there is no improvement on inflation, but perhaps slight improvement as a result of pneumatic massage.
(ii) As a means of diagnosis. If temporary improvement takes place it may be assumed that the stapes is not absolutely fixed, and that the deafness is partly due to adhesions preventing movements of the ossicles, a condition which may point to the advisability of performing ossiculectomy in suitable cases.
Operation. The ear is rendered insensitive by means of cocaine or Gray’s solution (see [p. 310]).
Fig. 197. Lucae’s Probe.