Myringotomy 1886. The vinyl tube used today was introduced by Beverley Armstrong in 1954. There are numerous indications for tympanostomy in the pediatric age group, the most frequent including chronic otitis media with effusion (OME) which is unresponsive to antibiotics, and recurrent otitis media. Adult indications differ somewhat and include Eustachian tube dysfunction with recurrent signs and symptoms, including fluctuating hearing loss, vertigo, tinnitus, and a severe retraction pocket in the tympanic membrane. Recurrent episodes of barotrauma, especially with flying, diving, or hyperbaric chamber treatment, may merit consideration. Myringotomy is usually performed as an outpatient procedure. General anesthesia is preferred in
What a piece of work is a man lines written by Montaigne: However, rather than being a direct influence on Shakespeare, Montaigne may have merely been reacting to the same general atmosphere of the time, making the source of these lines one of context rather than direct influence. What a piece of work is a man "What a piece of work is man!" is a phrase within a soliloquy by Prince Hamlet in William Shakespeare's play of the same name. Hamlet is reflecting, at first admiringly, and then despairingly, on the human condition. The soliloquy, spoken in the play by Prince Hamlet to Rosencrantz and Guildenstern in Act