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Article
February 3, 1917

CLINICAL TYPES OF LABYRINTHITIS: WITH COMMENTS ON TREATMENT

Author Affiliations

Fellow of the American College of Surgeons NEW YORK

JAMA. 1917;LXVIII(5):336-339. doi:10.1001/jama.1917.04270020016005
Abstract

Preliminary to a discussion of the clinical types of labyrinthine disease, may I remind you that the hardness of the labyrinthine capsule and its anatomic structure seem to be so arranged by nature that they form an unusually strong barrier against invasion by a purulent process?

It is estimated by Bezold that the labyrinth becomes involved only once in 500 cases of purulent otitis media. Friedich and Hinsberg, on the other hand, estimate its occurrence once in 100 cases. The latter seems to me more nearly correct. The most vulnerable points in the labyrinthine wall are the horizontal semicircular canal, the fenestra ovalis, the fenestra rotunda, the promontory and, from the cranial side, the internal autitory meatus. The labyrinth may be invaded by a purulent process from three sources: (a) from the middle ear, (b) from the blood currents, (c) from the meninges. Our cases come chiefly from the first-mentioned

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