The essential features of almost every method of treating chronically infected middle ears are the observance of scrupulous cleanliness and the addition of some bactericidal agent.
Cleanliness is necessary to remove the necrotic débris, which retains moisture, blocks drainage, produces adhesions by its irritative action on delicate tissues and forms a fertile soil for the many types of bacteria and fungi which often complicate chronic otitis media. The use of an antiseptic is of secondary importance.
In attaining the two objectives one finds almost insurmountable difficulties. Adequate mechanical cleansing of all the recesses of the middle ear is often difficult if not impossible. The procedure is frequently painful and is always attended with a certain amount of trauma, which sometimes causes it to defeat its own ends. It must be repeated so often by a physician that many patients because of living at a distance or for economic reasons are
MERTINS PS. USE OF UREA IN TREATMENT OF CHRONIC OTITIS MEDIA: PRELIMINARY REPORT. Arch Otolaryngol. 1937;26(5):509–513. doi:10.1001/archotol.1937.00650020563001
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