SEROUS CYST 431 



then held in position bj- means of an ear-cap (Figs. 152, 153). This dress- 

 ing must not be clisphiced, but allowed to remain for days. This method 

 has been an element of uncertainty; in some cases it acts perfectly and 

 in others, beyond setting up considerable irritation, it does not destroy 

 the secreting surface and the abnormal condition returns. 



McQueen's method is very simple and produces good results. He 

 carefully removes the hair from the ear and renders it antiseptic, and 

 either paints the ear with cocaine or administers chloroform, empties the 

 sac by means of an aspirator syringe, and makes sure that it is com- 

 pletely emptied. Sutures are then inserted radiating from the centre 

 of the sac, about one-third of an inch apart, directly through the ear and 



Fig. 153 — Ear hood or net. 



tied on the outer or hairy side, thus producing a firm pressure between 

 the two surfaces of the sac and by that means get prompt union. The 

 ear must then be irrigated with an antiseptic solution, carefully remov- 

 ing all blood, etc., and dressed with antiseptic wadding, and further 

 covered with an ear-cap. It should be dressed every day, and the sutures 

 removed at the end of a week. 



Another method consists in taking a scalpel and making a free 

 incision from one end of the sac to the other, then filling it in with 

 tincture of iodine, and then keeping it clean and using an ear-cap. 



Simple emptying by means of a trocar or making a small incision 

 never produces any good results, as the opening closes immediately and 

 it soon fills up again. Sutures are not advisable, causing great irritation. 

 In order to prevent the too rapid closing of the incision, the removal of 

 a small crescent-shaped piece of flesh from the edge of the opening has 

 been recommended. 



