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War Surgery and Medicine

Recommendations for the Future

Recommendations for the Future


In the medical boarding of recruits a careful history should be taken of any nasal or aural discharge, headache, nasal obstruction, sore throat, or operation. Every ear should be examined with an electrically lighted otoscope, or with a head mirror and ear speculum, and, if necessary, wax or debris removed till the drum is clearly seen. If necessary the cavity should be syringed with warm normal saline solution. If the drum cannot be clearly seen, or if there is any perforation or discharge, or if there is any history of aural disease, or any scar of previous operation, or any doubt, the case should be referred to a specialist.

Hearing should be tested under satisfactory conditions of quiet and space by test sentences or words by the spoken voice at ordinary conversation pitch at 20 feet distance, the ears being tested separately, one being shut off by a finger. When any doubt exists the hearing should be tested with an audiometer under the supervision of a specialist.

The pharynx should be examined and the ability to breathe through each nostril tested.


Men with any of the following disabilities should not be sent overseas: chronic otitis media, any large perforation of the drum, old radical mastoid operation, chronic sinusitis, nasal polypi, serious deafness.

page 458

Overseas there should be an ENT specialist for every general hospital, and one available for consultation on treatment and grading at the divisional level. Normally he could be attached to the CCS.


Higher rank should be granted to the senior ENT specialist, and specialist rank to any fully qualified specialist.


Specialists should not be appointed to field or administrative posts unless there is a full quota of specialists for clinical duties.


Sisters and orderlies trained in specialist treatments should be made available.


Special ear treatment rooms should be set up in base camps and in the divisional area with trained staff on call to carry out toilets and dressings.


Operations for remedial treatment in New Zealand, such as tonsillectomy, should be strictly limited, and likewise operations overseas, except for acute conditions.

Patients Invalided from 2 NZEF with Ear Disabilities
Battle Casualties Accidental Injuries
Rupture drum, bilateral, and otitis media 8 1
Rupture drum, bilateral, and deafness 47
Rupture drum, single, and otitis media 18 1
Rupture drum, single, and deafness 11 3
Rupture drum, bilateral 9
Rupture drum, single 15
Blast and deafness 4
Penetrating ear, with deafness 3
Other 5
ear sickness nose and throat
Otitis media 191 Sinusitis 61
Mastoiditis 8 Pansinusitis 4
Otitis externa 6 Rhinitis 6
Deafness, middle ear 19 Epistaxis 2
Nerve deafness 25 Cleft palate and obstr. 3
Catarrhal deafness 3 BC trachea 2
Mixed deafness 2 BC nose and loss tissue 1
Bilateral deafness 4
Otosclerosis 15
Other 6
admissions to hospital, 1941–45 (battle casualties)—
Rupture membranatympani 386
Mastoid region 30
Otitis media 80
Otitis externa 3
Nerve deafness 57
Contusions, etc 108