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Article
July 1937

SUPPURATION OF THE PETROUS PYRAMID: SOME VIEWS ON ITS SURGICAL MANAGEMENT

Arch Otolaryngol. 1937;26(1):42-48. doi:10.1001/archotol.1937.00650020048006
Abstract

Suppuration of the petrous pyramid is a serious complication of otitis media. By suppuration of the petrous pyramid is meant an infection of some part of the cellular structure surrounding the cochlea and the semicircular canals which usually localizes in the apical area as empyema. Thus the term apicitis or suppuration of the petrous apex is used. According to my figures, this condition occurs approximately once in every 300 cases of otitis media.

A majority of patients with this complication recover without resort to surgical intervention. In a small percentage of cases the disease does not localize but spreads by way of the vascular channels, causing fatal meningitis. This is usually a nonsuppurative lesion. No means of combating this type of the disease is available. The remainder of the cases constitute the 30 or 40 per cent in which the condition becomes a surgical problem.

The petrous portion of the

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