DISEASES OF THE EAR 



20II 



Fibromata. — We have often met with soft small fibromata 

 attached to the lobules of the ears of the negroes on the Gold 

 Coast, which can readily be removed. Perhaps the lipomata of 

 Loango are really soft fibromata. 



Keloid. — Keloid is met with on the auricle in West African natives, 

 arising after insignificant wounds, such as ear- piercing, etc., and may 

 form large tumours. 



External Auditory Meatus. 



Foreign Bodies are commonly met with in the tropics, and may 

 consist of animate objects, such as beetles, flies, etc.; or inanimate 

 objects, such as pieces of wood, etc. Usually their presence can 

 easily be determined by inspection, which should always be carried 

 out before any treatment is resorted to. The first treatment should 

 be to attempt to wash the body out of the meatus by means of 

 hot boracic lotion and an ear syringe, unless the body be a' pea, bean, 

 or grain of maize, because these would become swollen with the 

 water. Under these circumstances, it is better to instil some 

 glycerine mixed with a little rectified spirit and solution of cocaine, 

 which causes them to contract, when a camel's-hair brush dipped 

 in thick collodion may be carefully applied to the object. After 

 waiting a little time for the collodion to set, traction can be made 

 and the object removed. Failing these, attempts must be made 

 to remove the body by Guye's fenestrated forceps, Politzer's gouge 

 forceps, Troltsch's aural hook, an aural curette, or, in the case of 

 impacted steel bodies, the electro-magnet. If there is much swelling 

 of the mucous membrane of the passage, it may be necessary to 

 apply a solution of cocaine and adrenaline, after which extraction 

 may be attempted. It is often advisable to administer an anses- 

 thetic if a body is impacted in a child's ear. If all attempts fail, 

 an operation is necessary, which is generally performed by d taching 

 the auricle from behind and exposing the bone wall of the external 

 auditory meatus, a portion of which is removed if necessary. 



Animal Parasites.— Apart from foreign bodies, the following 

 animals have been found parasitic in the external auditory meatus: 

 CheyletidcB : C. heyletus, C. emditus Schrank, 1781. Tyroglyphidce : 

 Rhizoglyphus parasiticus Dalgetty, 190 1. DemodicidcB : Demodex 

 folliculorum Simon, 1842. Larvae belonging to the Anthomyidae, to 

 Sarcophaga carnaria Linnaeus, 1758, to WoMfartia magnifica Schiner, 

 1862, and to Chrysomyia macellaria Fabricius, 1794. 



Otomycosis. — Otitis externa parasitica, or otomycosis, is fairly 

 common in the tropics, and is due to a number of fungi, among 

 which may be mentioned: Mucor pusillus Lindt, 18S6; Lichtheimi a 

 corymbi/era Cohn, 1884; Lichtheimiaromosa Lindt, 1886 (these cause 

 otomucormycosis); Saccharomyces ellipsoides Rhees, 1870; Monilia 

 rhoi Castellani, 1909; Aspergillus fumigatus Fresenius, 1775; Asper- 

 gillus niger von Tieghem, 1867; Aspergillus flavus De Bary, 1870; 

 Aspergillus malignus Lindt, 1889; Aspergillus repens De Bary, 1870 

 (these cause otomycosis aspergillina). 



