Histological changes of incus with cholesteatoma in the attic.

In 160 cases of chronic otitis media with cholesteatoma in the epitympanum and intact ossicular chain, histological analysis of the incus was performed. The ossicles were cut in serial sections and every five cuts analysed. The findings were normal in 10.7%, a fibrous thickening of the periost was found in 13% of the cases. In 8% of the cases there was fibrosis of the periost with foci of active inflammation. Ostitis or osteomyelitis in the bone itself was present in 67.5%. In conclusion, removal of the ossicle during tympanoplasty was deemed necessary in 67.5% of the cases since otherwise relapse of the inflammatory process could sooner or later be expected.

[Our way in the treatment of middle ear carcinoma (author's transl)]. / Unsere Art, das Mittelohrkarzinom zu behandeln.

The treatment of middle ear carcinoma is in first place surgical, completed electrocoagulation and post-operative irradiation. The first intervention should be as radical as possible. But we do not consider that a total resection of the temporal bone should be routinely performed in each case. The range of the operation should be adapted to the size and localisation of the tumours process. It is impossible and unnecessary to preserve the labyrinth with a radical operation. The facial nerve can be preserved only in singled out cases. The retroauricular incision should be left open whenever possible because it helps to discover a relapse in due time and to apply radium, i.e., radioactive isotopes. A radical neck-resection should be performed only in case of a clinically obvious metastasis.