Cholesteatoma of the external auditory canal and keratosis obturans.

Keratosis obturans and external auditory canal cholesteatoma have often been regarded as a single entity. However, these are two distinct disorders with their own clinical presentations, physical and pathologic findings, and treatment. Keratosis obturans is an accumulation of obstructive desquamated keratin in the external auditory meatus. External auditory canal cholesteatoma is an invasion and erosion of squamous epithelium into a localized area of the bony ear canal. The origin of both entities remains obscure. The clinical symptoms, pathologic processes, and treatment are outlined and compared. Case reports are presented to illustrate the features of these two diseases.

[The "old radical" surgery. History and development of surgery of the mastoid]. / Die "alte Radikale". Geschichte und Entwicklung der Chirurgie des Warzenfortsatzes.

After a brief historical outline of the radical operation of the ear, the possibilities are presented which are at our disposal to construct a mastoid cavity after removal of the posterior bony wall of the auditory canal, thus keeping the problems for the patient at a minimum. At best, a small self-cleansing well-designed cavity is formed under favourable conditions. Important prerequisites for the construction of such a cavity are: A good overview obtained by smoothening of the cavity walls; widening of the auditory canal entrance (cartilage excision); removal of excess bone covering the facial nerve; and reducing the size of the cavity by means of a Palva flap while preserving the postauricular artery and its larger branches. Postoperative management (and cleansing) must be done with an operation microscope.

Mastoid development in ancient and modern populations. A longitudinal radiological study.

The effect of otitis media on the human mastoid process in a common milieu over a millennium was evaluated by comparing two present and four ancient populations. Temporal bone pneumatization patterns indicate that otitis media and mastoiditis existed in antiquity, and there were more altered pneumatization patterns in skulls from the era following European contact than from eras before European contact. Pneumatization patterns were similar in ancient skulls and in a preponderantly white male population mostly born before antibacterial availability. Both ancient and modern pre-antibacterial era temporal bones show more effect of otitis media during childhood than is found in present day schoolchildren. Reasons for differences are explored. It is inferred that upper respiratory tract infections were prevalent in the Upper Missouri River Basin during the past millennium. Furthermore, microbiological agents with virulence similar to today's flora were prevalent in this region more than 1,000 years ago.

The operation and death of Henry Schliemann.

Henry Schliemann's reputation as an archeologist, a linquist, a financial genius and a scholar is seldom recognized by Americans. His discovery of the ruins of Troy changed Homeric myths and legends into history and made him the founder of Aegean archeology. Recent popular books on Schliemann sketchily describe him otologic problems which eventually led to his death of an otogenic brain abscess. From a number of bibliographic sources, the details of Schliemann's ear history and the final months of his illness are recounted. The important information of Schliemann's ear operation by the famous Professor Swartze is presented.