Title: War Surgery and Medicine

Author: Stout, T. Duncan M.

Publication details: Historical Publications Branch, 1954, Wellington

Part of: The Official History of New Zealand in the Second World War 1939–1945

This text is the subject of: ‘Something of Them Is Here Recorded’: Official History in New Zealand

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RNZAF Experience in Pacific

The sickness rate for ear diseases was found by the RNZAF in the Pacific to be more than three times the New Zealand rate in 1944–45 (33.6 as against 9.8 per thousand per annum). The increase was principally due to a high incidence of otitis externa and otitis media in the Pacific. The warmth and humidity encouraged all bacterial and fungoid growth, and it was thought that minute particles of sand or coral in suspension in swimming water were causative agents. Most cases of otitis externa were found to have occurred in those who had been swimming within the preceding week. Sea water was the chief offender, probably owing to contamination by drainage from camps and refuse from ships, but bathing and diving in fresh-water pools in the coral also preceded infection. The primary lesion was thought to be caused by small abrasions of the lining of the external auditory meatus by particles of coral or sand, with bacteria from the water or air rapidly invading the wound and producing infection. With appropriate treatment healing occurred rapidly, the infection page 456 subsiding within ten to fourteen days. In the absence of any or appropriate treatment the condition would become chronic and remain so for weeks. In all cases there was a marked tendency to recur.

The most important part of the treatment was considered by Squadron Leader A. North, at Espiritu Santo, to lie in the constant and careful personal examination and supervision by the medical officer himself at all stages. In his opinion the commonest cause of recurrence was incomplete healing in the medial parts of the external auditory meatus at the time the patient was discharged as cured. In a series of 44 cases of otitis externa he found that the most effective and reliable treatment consisted in cleansing the meatus daily, insertion of cotton-wool wicks soaked in 10 per cent sodium sulphadiazine solution for three to five days till dry, followed by daily insufflations with 0.75 per cent iodised boracic powder till healed. Results of treatment with propamidine 0.1 per cent suspension in water soluble jelly base were not as good. From experience at the hospital at Espiritu Santo it was suggested that, if practicable, a separate ear clinic be held where there were a number of cases of otitis externa. One tray could be set up and the instruments re-sterilised between each case. This allowed better observation, attention, and concentration on treatment, also saving time for both patients and staff.