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of infection of the external canal, being employed to relieve an itching of the ear. The infection is usually followed by much pain and temporary deaf- ness of the aff'ected ear. due to the mechanical inter- ference with the waves of sound in reaching the drum. It is advisable to explain to patients with such tendencies that the only safe thing 100 mg topamax to be used for the ear is the elbow. The perfect function of hearing is dependent upon equal atmospheric do i need a prescription for topamax pressure existing upon both sides of the tympanic membrane. To maintain this, the Eustachian tube must admit air into the topamax generic weight loss middle ear cavity. When the lining membrane of this tube is inflamed or congested, or blocked with secretion, the equipoise of the drum is disturbed and the hearing diminished in proportion. When this is continued for a long period, the hearing is permanently in- jured, especially when the catarrhal process migraine prescription topamax involves the middle ear cavity. In children, this condition is most frecinently due to hypertrophy of the pharyn- geal tonsil, topamax 50mg and weight loss buying topamax online the so called adenoiils of topamax 100 mg weight loss the naso- j)harynx. Even in cases in which the hypertrophy is not sufficient to seriously interfere with nasal breathing, its effect on the ear is marked and there- fore calls for ]irompt surgical topamax generic vs brand relief. Suiipurative inflannnation of the middle ear is a frequent cause of deafness. As soon as pressure against the drum is observed in such cases, a free incision sbouki be made. The neglect to do this will not only prolong the suffering of the patient auvl expose him to the danger of a mastoid complica- tion, but the natural bursting through the drum de- stroys more tissue, which may leave a noticeable de- fect in the hearing. Acute suppurative inflamination of the middle ear. when properly treated, should result in closure of the drum in practically every case, leaving no pcr- cciitit>le defect in the hearing. When neglected. rr( \triU- 442 II. -I I. LOCK: NEURASTHENIC NEURALGIA. however, or improperly treated, topamax mg for weight loss it tends to develop a chronic suppurative process with its dangers of mastoid involvement and impaired hearing. When the chronic suppuration in these cases is finally ar- rested, a result that topamax generic availability is usually obtained only after patient and prolonged treatment, the perforation nearly always persists, and its subsequent closure is not only sometimes impracticable, but requires buy topamax online without script great manipulative skill on the part of the aurist. Hence the topamax generic brand importance of the prompt and careful treatment of such cases during the acute stage. Nasophar\'ngeal catarrh is an important factor in the development of ear disease and consequent im- pairment of hearing, and is the more important on account of its great frequency. The presence in the nasopharyn.x of a secretion in which pathogenic microorganisms are nearly always present, is a con- stant menace to the ear on account of its proximitv to the orifice of the Eustachian tube. In addition to this, the efforts of the patient to dislodge the secretions tend mechanically to injure the topamax order online delicate mechanism of the middle ear, so that even in such cases non prescription topamax where there is no evidence of disease of the ear, the function of hearing is_ nearly; order topamax canada always below the normal. Nasopharyngeal catarrh should there- fore be treated with the care and perseverance that its importance demands and not be neglected as a necessary evil, need prescription topamax as so many persons do. All forms of topamax order nasal disease or abnormities are a source of danger to the ear. The purulent forms, whether due to suppuration of the nasal mucosa 'or of one of the accessory sinuses, may extend by con- tinuity to the Eustachian tube and develop a sup- purative inflammation of the middle ear with its dan- ger to health and audition. This is especially the case in infants who are unable to clear the nasal passages. As purulent rhinitis in children is fre- quently considered a prolonged " cold," the impor- tance of explaining the danger to the parents is self evident. Nasal obstructions, whether due to saeptal defor- mities, tumors, or hypertrophies, tend to create dis- eases of the ear. There get prescription topamax have been discussions as to whether this is due to the decrease of air pressure around the orifice of the Eustachian tube, and there- fore in the middle ear, resulting from the nasal ob- struction, or whether it is due to the secretions lodg- ing around the Eustachian tube in such patients, but in either case the removal of the obstruction is indi- cated in order to preserve the hearing. While on the subject of nasal disease it is well to call attention topamax generic price to the danger to the ear of the nasal
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