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Article
March 1931

UNLOCKING OF THE PETROUS PYRAMID FOR LOCALIZED BULBAR (PONTILE) MENINGITIS SECONDARY TO SUPPURATION OF THE PETROUS APEX: REPORT OF FOUR CASES WITH RECOVERY IN THREE

Author Affiliations

NEWARK, N. J.

Arch Otolaryngol. 1931;13(3):386-422. doi:10.1001/archotol.1931.04230020072005
Abstract

The chief objects of this communication are to show that from the character of the temporal bone (1) infection of the marrow-containing petrous apex is a different pathologic process—a true osteomyelitis—from suppuration of the pneumatized cells of the mastoid; (2) that different principles of treatment are consequently applicable, and (3) that in a surgical attack on the apex, the squama and tympanic ring may be removed, as all the external portion of the temporal bone is solely for protection of the neural tissues of the labyrinth and the brain.

SURGICAL PATHOLOGY  The temporal bone, from a physiologic standpoint, is composed of three portions. 1. The first is an external protective portion made up of the squama, tympanic ring and mastoid with its pneumatic cells.The squama and tympanic ring are membrane bones which phylogenetically are a secondary type of bone, while the mastoid portion is the lateral arm of

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