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September 1962

The Chronic Ear: An Unorthodox View

Arch Otolaryngol. 1962;76(3):216-221. doi:10.1001/archotol.1962.00740050224005

Opening a discussion on attic suppuration in May, 1950, my early remarks included this statement:1 "The terms of reference are narrow, yet it may be useful to begin with a study of lesions which are not now suppurating; and later to discuss things which do not appear to suppurate at all." Reviewing the lively encounter of that morning, it seems that the paramount importance of case history was well established. There was already a tiny seed of doubt about the very existence of chronic suppurative otitis media, and the abolition of the cholesteatoma doctrine was impending, excepting only the congenital petrous type. What then applied to the epitympanum has gradually spread to the chronic ear problem as a whole. I believe that a sufficient number of careful histories will demonstrate the absurdity of traditional ideas of pathogenesis, that the notion of cholesteatoma when regarded as belonging to the middle