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(ii) no unhealed (unclosed) perforation of the tympanic. membranes except that a dry perforation of non-infectious origin need not render the applicant unfit:
(iii) no permanent obstruction of the Eustachian tubes;
(iv) no
vestibular permanent disturbances of the apparatus,
(Note: The details of the Hearing Requirements are specified in regulations 200 to 213.)
{h} Nose, throat and mouth examination.
There shall be free nasal air entry on both sides. There shall be no serious malformation not serious, acute or chronic, affection of the buccal cavity or upper respiratory tract. Applicants with significant defects of speech will be assessed as unfit.
200, Physical Standard No. 4- -The medical examination and assessment will be based on the following requirements of mental and physical fitness-
(a) The applicant shall be required to be free from such active or latent, acute, or chronic, physical disability, as would entail a degree of functional incapacity which is likely to interfere with the safe performance of the duties at any altitude throughout a prolonged or difficult flight. (5) The medical examination will include a full inquiry into the family and personal history of the applicant. The information obtained shall be given in a statement made and signed by him and will be taken into consideration by the medical examiner.
(c) Examination of the nervous systent.-The applicant shall have no history of significant mental or nervous trouble, He shall be required to be free from any mental impair- ment, or presumptive evidence of latent epilepsy. He shall be required to be free from any progressive disease of the nervous system and from any non-progressive disease of that system, the effects of which are likely to interfere with the sale performance of the duties. Cases of past or present insanity and cases in which syphilis, past or present, has affected the central nervous system will be assessed as permanently unfit.
As to injuries of the head-
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(i) Cases of simple concussion, or simple fracture of the skull without associated intracranial injury will be assessed as temporarily unfit until such time as the medical examiner is satisfied that the effects of the concussion or fracture are no longer likely to jeopardise safety in flight. If the applicant has been incapacitated for a period in excess of une month the licence if renewed will be valid only for a period of two months in the first instance, thereafter its validity will be restricted to consecutive periods of two months until the medical examiner is satisfied that the after-effects of the concus- sion or fracture are no longer likely to cause a sudden incapacity in flight.
(ii) Cases of head injury associated with intracranial injuries will be assessed as permanently unfit if a local lesion of the brain or meninges persists.
(iii) Cases of head injury in which there has been an operation on the skull with loss of bony substance involving the two tables of the cranial vault will be assessed as permanently unfit.
(d) General surgical examination.
The applicant shall required to be completely free from hernia,
Cases of active disease of the bones, joints, muscles or tendons and all serious functional sequelae of con- genital or acquired disease will be assessed as unfit. Cases of functional after effects of lesions affecting the bones, joints, muscles or tendons and certain anatomical defects compatible with the safe performance of the duties may be assessed as ft.
Cases of sequelae of disease or surgical intervention on any part of the digestive tract and its adnexae, liable to cause sudden incapacity in flight, in particular any obstructions due to stricture or compression will be 1ssessed as unfil.
Cases of extensive mutilation of the chest wall with collapse of the thoracic cage and sequelae of surgical procedures resulting in decreased respiratory efficiency at altitude will be assessed as unfil.