496 DISEASES OF THE EAR 



Symptoms.— The presence of a thick, white, glutinous dis- 

 charge either into the auditory meatus or to the outside 

 should be regarded with suspicion and the parts thoroughly 

 examined. Often the hair will be removed at the point of 

 discharge and the material 'collect, become dried and form 

 crusts. Pressure over the region will often reveal the point 

 of discharge. The introduction of a small flexible probe will 

 make the diagnosis positive. There is in nearly all cases 

 some enlargement in the tissues adjacent to the fistula. 



Prognosis.— All fistula? involving the cartilage of Ae ear 

 should not be considered in favorable light. As the process 

 is a progressively destructive one, healing is difficult. 



Treatment.— The part should be shaved and cleansed 

 thoroughly. Introduce a flexible probe to determine the 

 extent of the fistula and the tissue invaded. A free opening 

 is made and all necrotic tissue removed. Pack the wound 

 with iodin gauze. A head bandage should be employed to 

 keep the pack in position. Dress the wound daily. After 

 a few days it may be treated as an open wound. Some cases 

 will require amputation of the concha. This, however, 

 should be avoided if possible. 



