LXXVII Medical Care and Prophylaxis in Hearing Losses with Special Attention to Allergies

Prior to the advent of the sul£onamides, penicillin, streptomycin and other antibiotics, otology was considered primarily a surgical specialty and treatment aimed at the prevention of deafness was almost entirely surgical. Since these therapeutic agents have come into general use, however, the character of the entire practice of otology has changed to the point where surgery now plays only a secondary role in preventing hearing loss. The removal of tonsils and adenoids, submucous resection of the nasal septum, surgical treatment of chronic infective sinusitis and early paracentesis for acute middle ear abscess, are still considered important as prophylactic measures in potential deafness. Mastoid surgery for acute otic infection of the temporal bone, however, is pretty much a thing of the past. Our change in otologic thinking has been greatly influenced by evidence which has accumulated over the past several years pointing to unbalanced diet; vitamin, mineral and protein deficiencies; glandular dysfunction; psychology factors; inherited predisposition; and allergy as playing vital roles in the etiology of various types of deafness. The fact that otology was considered predominantly a surgical specialty for so many years may be one reason why the medical approach to the prevention of deafness has been so long neglected and why allergy as a possible etiologic factor has received so little attention. Since time does not allow for detailed consideration of all of the medical aspects of the subject, this discussion will be limited to the allergic phase of the problem.