In any case of acute or chronic middle ear inflammation, where there is a collection of pus within the middle ear, there is danger of extension of the inflammation to the mastoid cells. It is a question whether the mastoid is not involved to some extent in all cases of acute middle ear inflammation, as well as in all cases in which a chronic suppuration of the middle ear has existed for a considerable period of time. Naturally this statement is not meant to imply that the mastoid involvement requires any interference on the part of the surgeon, the condition disappearing on appropriate treatment of the middle ear. It is hardly conceivable, however, that in two regions so closely associated and so intimately connected as the pneumatic spaces of the mastoid and the tympanum, one part could be the seat of an inflammatory process without some slight extension to the
DENCH EB. THE DIAGNOSIS AND TREATMENT OF MASTOIDITIS. JAMA. 1901;XXXVII(4):247–254. doi:10.1001/jama.1901.62470300015001f
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