Course  and  Symptomatology. — Chronic  catarrhal  inflammation
gradually  extends  to  the  middle  ear,  bringing  about  a  condition  of
hyperplasia  of  the  mucous  membrane,  and  resembles  sclerosis  of  the
middle  ear.
Treatment. — Stricture  of  the  tube  should  be  destroyed  by  inflation,
electrolysis  or  hard-rubber  filiform  bougie.  The  bougie  should
not  be  passed  oftener  than  once  weekly.  Where  the  ostium  tuba  is
swollen  or  covered  with  a  mucous  exudation,  a  fifty  per  cent,  solution
of  argyrol  should  be  applied  to  the  mouth  of  the  tube  with  a  cotton-
tipped  probe,  or  two  or  three  drops  injected  into  the  catheter  with
a  syringe  and  forced  into  the  Eustachian  tube  with  a  Politzer  bag.
Where  mucus  continues  to  occlude  the  tube,  the  fumes  of  sal-ammon-
iac may  be  injected  twice  weekly.  An  oil  solution  of  camphor,
menthol  and  iodin  may  be  injected  into  the  Eustachian  tube  through
the  catheter  twice  weekly  for  five  or  six  weeks.  The  Eustachian  tube


252  DISEASES   OF   EAR,    NOSE   AND   THROAT.
should  be  inflated  once  weekly  during  this  period,  until  recovery  is
complete  or  the  progress  of  the  disease  is  brought  to  a  standstill.
External  massage  to  the  neck  is  recommended.  Any  abnormal
condition  in  the  nose  and  throat  should  be  corrected.
Ulceration  of  the  Pharyngeal  Orifice  of  the  Tube. — Ulceration
of  the  orifice  of  the  tube  may  be  due  to  infection,  syphilis,  tuberculosis,
diphtheria  and  carcinoma.
The  course  of  the  disease  is  variable  and  depends  particularly  upon
the  early  detection  of  the  ulceration  and  the  cause  of  the  disease.
Marked  destruction  of  the  orifice  may  occur  if  the  ulceration  is  very
great,  bringing  about  adhesions,  scars  and  atresia.
Treatment. — The  treatment  is  both  local  and  general.
