• Deaths from the complications of otolaryngological infections declined sharply after the advent of sulfonamides and antibiotics. The practice of the otolaryngologist has changed accordingly, and most patients now need good differential diagnosis, instruction in hygiene, psychotherapy, and medication rather than surgery.
The frequency of mastoidectomies has diminished, but recent experience with ear infections shows that myringotomy has sometimes been neglected. Many patients with chronically discharging ears need surgical treatment, including radical mastoidectomy.
A patient with vertigo, tinnitus, or impaired hearing should have complete auditory and vestibular tests. Patients needing fenestration are referred to men especially skilled in this type of work, and urgent cases of respiratory obstruction can be handled best by specialists with requisite experience and equipment. The complaints of many patients prove to have a psychosomatic basis. Cancerophobia is frequent, but tumors are not infrequent. Patients who need radical cancer surgery should be referred to men who do this frequently.