Læknablaðið - 01.06.1972, Blaðsíða 43

LÆKNABLAÐIÐ
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in all three cases immediate hearing improvement took place post-operatively
with gradual deterioration later on. These patients have to be reoperated.
In one case, only the lenticular process of the incus was missing, in
which case the gap was bridged with a plastic tube. Normal hearing was
regained.
In five ears the stapes arcade was missing. Two of these were operated
a.m. Offermann, as the ineus was missing too. Both achieved good hearing
immediately after the operation, but both cases, especially one of them, have
shown gradual deterioration since. In two cases, stapes fracture was found.
In one of these, homograft bone was placed between the incus and the stapes
footplate and in the other a plastic tube. Both regained normal hearing.
In the fifth case, the arch of the stapes and the long process of the incus
had been destroyed by cholesteatoma. The remnants of the incus were re-
positioned with the short process resting on the footplate. Hearing was im-
paired by 10 dB.
The last two cases were traumatic dislocations of the incus. In both
cases, bone conduction threshold was very poor. In one case the incus and
the stapes were connected with wire and in the other with a plastic tube.
Hearing improvement was 20 dB in both cases. Neither ear, however, re-
gained serviceable hearing.
In the latter category, hearing has improved in 80% of the cases, re-
mained the same in 15% and deteriorated in 5%.
All operations in both categories were performed under local anaesthesia
and all patients were ambulant. In cases of incus transposition or simular
procedures, however, three to four days of the rest in bed were recommend-
ed. Antibiotics were given orally for a week or two. No packing or dressing
was used. A cotton pad only was placed loosely in the outer ear canal. The
youngest patient was 5 and the oldest 76 of age.
The author considers it a great advantage not to have any packing in
the ear canal to enable one to follow the process of healing from day to day
and to take any necessary measures when indicated.
Læknirinn kom úr þriðju næturvitjuninni, skreið í rúmið og hét
því, að ekkert skyldi fá hann til að fara fram úr aftur þá nótt. Tíu
mínútum seinna hringdi síminn.
„Svaraðu,“ hvæsti hann til konu sinnar. „Ég er ekki heima.“
Frúin teygði sig yfir rúm læknisins og tók símann.
„Halló, nei, hann er ekki heima. — Nei, ég veit ekki, hvenær
hann kemur heim. Það getur dregizt. Hvað er að?“
Hlustar.
„Nú, tannpína. Hve gömul er hún?“
Hlustar aftur.
„Nú, er hún þriggja ára.“
Frúin horfir spyrjandi á lækninn, sem hvíslar: „Heitan bakstur.“
„Gætuð þér ekki reynt heitan bakstur?“
„Nú, þér hafið reynt það.“ Lítur aftur á lækninn, sem hvíslar:
„Hálfa magnyl.“
Hlustar aftur.
„Hafið þér reynt það líka?“ Lítur eymdarlega til læknisins. Hann
hvíslar enn, reiðilega: „Pensla með joði.“
„Þá finnst mér, að þér ættuð að reyna að pensla með joði.“
Þögn. Síðan heyrist í símanum:
„Fyrirgefið, að ég spyr, en er herrann, sem liggur hjá yður, líka
læknir?“