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It has been customary to treat open surface infections with antiseptic solutions. The obstetrician has treated acute infections by intra-uterine douching, but has found that such irrigations in acute infections apparently spread the infection occasionally into the peritoneal cavity. Some otologists have suspected that irrigation of the ear in acute otitis media may tend to spread infection to the mastoid. The analogy between the mastoid and the peritoneal cavity is not very close. The latter is a collapsible space, with no positive air pressure from within, controlled by the abdominal muscles from without and the organs from within. Fluid may enter readily as the abdominal muscles relax. On the other hand, the mastoid air spaces have rigid, bony walls and the entrance is from one inlet, which is also the outlet for the air. This is the aditus ad antrum. When solutions are irrigated into the middle ear they
SHAPIRO D. IRRIGATION OF THE EAR IN ACUTE OTITIS MEDIA: IS THERE RISK OF SPREADING THE INFECTION TO THE MASTOID CELLS? Arch Otolaryngol. 1933;17(3):384–385. doi:10.1001/archotol.1933.03570050372006
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