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Recently great interest has been aroused in all phases of suppuration of the petrous pyramid. Critical observers are gaining a clearer insight into the disease. Assuring reports are now forthcoming to support the view that suppuration within the petrous bone has a marked tendency to spontaneous cure. However, in the instances in which surgical intervention becomes imperative it is logical to employ an approach which makes it possible to drain that part of the pyramid in which disease most often occurs.
Our microscopic sections of temporal bones show that in the vast majority of cases of suppuration of the petrous pyramid the infection spreads from the middle ear and antrum through the superior and posterior perilabyrinthine groups of cells and that the greatest expression of the disease is situated between the superior semicircular canal and the internal auditory meatus. It is obvious, then, that the surgical approach for