Because of an increasing interest in suppuration of the petrous pyramid and the accumulation of greater experience in the management of this condition it is to be expected that new ideas and methods of treatment will be evolved. It is becoming a well established fact that a fistula extending into the apex area through a pneumatized pyramid is frequently present in cases of suppuration of the petrous pyramid. It is questionable, however, whether such a fistula can be discovered in every case. Perhaps progress in the surgical management of this condition will some day enable otologists to determine this.
This article deals with the management of suppuration of the petrous pyramid when a fistula is found above the plane of the horizontal semicircular canal, external (lateral) to or above the plane of the superior semicircular canal and beneath the cortex of the anterior surface, which is called the superior