=Other methods of extraction= are--(1) _Drilling through the foreign
body_, if it is a hard substance, and then inserting a fine hook into
the opening so made. (2) _The agglutinative method_, which consists in
dipping a small paint-brush into a concentrated solution of seccotine or
glue and then inserting it into the meatus until it comes in contact
with the foreign body. The brush is left in this position for several
hours in the hope that it may become adherent to the foreign body; if
so, on withdrawing the brush from the ear, the foreign body should be
extracted with it. This method can only be used provided the ear is kept
dry.
These procedures, although said to be successful in a few cases, are not
recommended.
=After-treatment.= If the tympanic membrane and auditory canal have not
been injured, it is sufficient to dry the meatus and puff in a little
boracic powder. If there be abrasions of the canal, a small strip of
gauze should be inserted and changed as frequently as it becomes moist
with secretion, the meatus, if necessary, being also syringed out with
an aseptic lotion. If there be acute inflammation of the walls of the
canal, accompanied by much swelling and purulent discharge, drops of
glycerine of carbolic (1 in 10) may be instilled frequently. After the
inflammation has subsided, an alcoholic solution of 1 in 3,000 biniodide
of mercury may be employed. If the tympanic membrane has been injured,
either from the presence of the foreign body itself or from the attempts
at extracting it, the treatment is similar to that for an ordinary
middle-ear suppuration.
=Removal by operation.= This may be done in the following ways:--
=By means of a post-aural incision.=
=Indications.= (i) If prolonged attempts to remove the foreign body by
instruments have failed. This operation becomes imperative if there are
signs of retention of pus within the middle ear.
(ii) If the foreign body has been pushed into the tympanic cavity and
cannot be removed otherwise. In such cases, if the perforation is large
and the foreign body is small, an attempt may first be made to dislodge
the substance by injecting fluid into the middle ear through the
Eustachian tube by means of the catheter and syringe (see p. 372). This
method, however, is rarely successful.
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