Tuberculosis of the temporal bone was described as far back as the early eighteenth century, by Jean Louis Petit.1 In the first half of the nineteenth century the teaching of Laennec with respect to pulmonary tuberculosis led other workers to study the tuberculous changes in the temporal bone in patients with this disease. Eschle2 first identified the tubercle bacillus in a lesion of the ear in 1883, only one year after Koch's discovery of that organism. In 1885 Habermann3 first demonstrated tuberculous lesions in the tympanic mucous membrane. In the eighteen nineties the routes of infection were studied theoretically and clinically. The theory that the eustachian tube was the portal of entry was favored by some,4 while others favored the idea that infection was carried by the hematogenous route.5 In 1913 Brieger4a attempted to classify tuberculous otitis media as lupoid, infiltrating, fungoid or necrotizing. In 1922 Leegaard6 expressed disapproval of