The Surgical Treatment of Chronic Suppuration of the Middle Ear And Mastoid

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Buck further states that the operator may then satisfy himself that he has reached the antrum by his knowl- edge of the anatomy of this region telling him whether the cavity which has been reached fulfils in a general way the anatomical requirements or not. If its distance from the surface of the bone by actual measurements is less than one half inch, it would simply indicate an outlying cell. By introducing a probe bent at nearly a right angle with its shaft, in case of the antrum being opened... it will slip forward into the posterior end of the tympanum, while if it be but an outlying pneumatic cell, the probe would encounter only a rigid wall. This may also be ascertained, he states, by forcing fluid or air under moderate pressure in the tympanic cavity by way of the external canal, and it will then come out through the antrum, but any pressure in the reverse direc- tion should not be used. If a depth of three-quarters of an inch has been reached without finding the antrum, one should not go to any further depth, as the chances are the opening is either too low down, too high, or too far back- wards, and under such circumstances, if the operator is in the right direction and he is sure the antrum is not present, then he may work cautiously forward until the tympanum is reached.

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