Abstract
The treatment described is the rational sequence, dependent on the writer's vasomotor explanation of otosclerosis. It consists in the local application of thyroxine to the ear. Many years ago it was observed by the writer that thyroid extract applied locally to the mucous membrane of the nose produced an active congestion without inflammatory reaction and lasting for a long time. If otosclerosis is the result of a defective vasomotor response in the small blood-vessels of the ear, then thyroxine locally applied might overcome this defect.
Fourteen cases were treated and very considerable improvement resulted in seven of these (50%). Of these seven, tinnitus was greatly relieved in those in which that symptom was present. Wax also began to be secreted again. The subjective symptom of paracusis, usually considered of very unfavourable significance, is no contra-indication to this method of treatment, as two of the most successful cases were the subjects of paracusis.
The method of application is very simple and is described in full in the paper.
Cases which are not suitable for this treatment are very advanced cases, and those in which there is any serious loss of bone conduction, or in which the loss of hearing for high notes is marked.