The occurrence of artificial communicating passages between the meatus and attic of the middle ear is, on the whole, little referred to in literature; it is mentioned, but not commented upon, in some of the larger text-books. Some illustrations of it are given in Politzer's "Beleuchtungsbilder des Trommelfells," etc. Yet it is not a rare lesion, as I have seen considerably over 20 instances, and can refer now to some 20 complete records. The last 12 cases were found amongst 2000 ear patients. The defect is, usually a fissure of variable size in the external wall of the attic, opening through the upper wall of the meatus above Shrapnell's membrane. In some instances it seemedto be a fistula instead of a complete gap, but it is not always possible to distinguish between two conditions.
Small defects are difficult to recognize by sight and may be found only by the use
RGRADLE H. BONY DEFECTS AND FISTULÆ IN THE EXTERNAL MEATUS.. JAMA. 1901;XXXVI(9):546–550. doi:10.1001/jama.1901.52470090010002b
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