EAR IRRIGATION — the medical procedure applied to removal of cerumen impaction or a foreign body from outside acoustical pass.
Before P. at. carry out otoskopiya (see), also find out whether was at sick suppuration from an ear, to-rogo so-called dry perforation of a tympanic membrane can be a consequence. For P. at. use warm liquid (t ° 37 °) not to cause irritation of a labyrinth and unpleasant feelings connected with it in the patient (dizziness, nausea, vomiting, etc.). In the absence of a perforation opening of P. at. it is possible to carry out by water, and in case of perforation surely it is necessary to use disinfecting solution (e.g., solutions of Furacilin, Rivanolum, potassium permanganate, 3% solution boric to - you, etc.).
The item at. make by means of a Janet's syringe or a rubber bulb with a bone tip with a capacity of 100 — 150 ml. The patient sits and holds a reniform tray, densely pressing its edge to the lateral surface of a neck under an auricle (in a tray wash liquid from an ear gathers). For straightening of a natural bend of outside acoustical pass the auricle at adults is delayed the left hand of a kzada and up (the child has kzad and from top to bottom), and the right hand the tip of the syringe or a rubber bulb enter into outside acoustical pass not more deeply than on 1 cm. The fluid jet in the separate portions tolchkoobrazno, under small pressure is directed to a posterosuperior wall of outside acoustical pass. It is not necessary to direct it under the big pressure upon a tympanic membrane since it can cause its gap and sharp ear pain. Filling the syringe or a rubber bulb with liquid, watch that in them there was no air since air traps, mixing up with water, cause during the washing strong noise in an ear, unpleasant for the patient. Cerumen impaction in most cases entirely, sometimes separate pieces is washed away in a tray by a reversed current of liquid. After washing the head of the patient is inclined on one side that liquid flowed out. Then it is necessary to drain completely by means of an ear speculum outside acoustical pass by cotton wool, navernuty on the probe and to establish whether cerumen impaction is removed and whether the tympanic membrane is whole.
At cerumen impaction, completely occlusive outside acoustical pass, follows before P. at. under control of sight to separate a stopper the stupid probe from a verkhnezadny wall and to send a stream of wash liquid to the formed crack. Sometimes cerumen impaction does not manage to be removed at once, then it is necessary to soften previously it alkaline drops. At an epidermal stopper accumulation of desquamated epidermis (a dense consistence, closely stuck together with skin of outside acoustical pass) P. at. make after preliminary injection in an ear of salicyl alcohol or mix of equal parts of alcohol and glycerin.
Washing away foreign bodys (see) make surely after an otoskopiya and definition of character of a foreign body and carry out also, as well as removal of cerumen impaction. Live foreign bodys (insects, etc.) kill previously, pouring in an ear in several drops vegetable Mas of la of a pla of the warmed-up alcohol. At the inflated and densely wedged foreign body (peas, haricot, etc.) P. at. make after preliminary injection in an ear of the warmed-up alcohol. At P. at. the fluid jet cannot be directed directly to a foreign body since it leads to pushing through it in deeper departments of outside acoustical pass that involves need of the subsequent use of other methods of extraction of a foreign body, up to operational.
Bibliography: The multivolume guide to otorhinolaryngology, under the editorship of A. G. Likhachev, t. 1, page 114, t. 2, page 22, M., 1960.
V. P. Gamov.