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(}. I.anirinaiiii, Now Y'ork F. v.. Millor, New Yolk ,1. (>. I). Ciillon, Kiihinond, Vu I., llaupt, Now Y'ork ('. M. Siiiolds. KielimoHd, Va \V. II. Knap, Mlooiuiii^lon, 111 F. DoiiiiMsoii, .If., Haltiiiiore, Md J. A. lvol>iii.-Buy Trihexyphenidyl Online East Fifty-seventh Street. THE OPERATIVE TREATMENT OF A CASE OF Purchase Artane HYPEROSTOSES OF THE EXTERNAL AUDITORY CANAL.* By THOMAS R. POOLEY, M. D. The object of this paper being mainly to describe the operative treatment of an osseous tumor, or rather tumors of Buy Trihexyphenidyl the auditory canal, very little time will be given to the consideration of their causation or pathology Artane Tablets except so Buy Artane Online far as may be necessary to a differential diagnosis of the case before us. The terms exostoses or hyperostoses are quite generally used interchangeably. Capsell (" Transactions of the In- ternational Medical Congress," London, 1881) accepts two kinds of osseous formations — hyperostoses and exostoses — varying in Order Trihexyphenidyl Online regard to origin, size, form, and structure. Hy- perostoses are hyperplasise. They occur Artane Online only in the inner portion of the osseous meatus, and never before complete ossification of the latter. They are of the consistence of ivory, have no pedicle, and are immovable, of conical form, and stand in no relation to other affections of the ear. The Purchase Artane Online seat of exostoses proper is the boundary between the osse- ous and cartilaginous meatus. They are always peduncu- * Read before the Medical Society Order Artane Online of the State of New York at its eighty-third annual meeting. latcd, Klightly movable, and of very divcrwe form. Unlike the liyporostosiH, several exontoHes are never found at the same time. Yet the two forniH may oecur together. Ac- cording to von TroltHch, however, no Hharply (btfiiied line sc|iarateH the exoKtoHCH from the livpcrostoseH ; but In; ap- plies the latter term to those difTime growths occupying the whole length of the meatus, and "exostOHca" to circuin- s(rribed, tumor-like, oHseous now formatiouH. If we, then, prefer the term hyper()Mloses, it Ih, after all, to be considered as a more or arbitrarv distinction. Tlu; surgical treatment of these growths has hitherto i)(;eii very unsatisfactory ; and this is not to be wondered at when we consider the ivory-lik(! dcMisity of the tumor and its situation. Nor is the danger all surmounted even when we have succeeded in the removal of the bony tumor, for the sub- sequent inflammation of the walls of the auditory canal is very likely to result in atresia, or even complete closure. Or an acute inflammation of the middle ear may result through wounding Order Trihexyphenidyl the Generic Artane membrana tympani, or an extension of the inflammation to the parts by continuity. It can not, therefore, he wondered at that all sorts of compromises in the way of treatment are recommended and resorted to be- fore any surgical procedure is tried, such as local painting with a tincture of iodine and caustic solutions, the internal administration of mercury and iodine when the disease is supposed to have a syphilitic basis, and, when the growth has reached such a size as to interfere with hearing, attempts at dilatation. Such procedures, however, seem to be tedious, of very doubtful use, and Buy Cheap Artane to the last Purchase Trihexyphenidyl Online degree tinsurgical. So long as the growths produce no unfavorable symptoms, it is far bet- ter to let them alone ; but, when they have reached such a size as to cause contractions of the meatus, so that cerumen and epidermic masses accumulate behind the stricture, to in- terfere with the hearing, and to produce Artane 2 Mg a feeling of disten- sion in the ear and pain and weight in the affected side Artane Price of the head, we are justified in attempting the operation for

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