have stimulated a widespread interest in the subject of suppuration of the petrous pyramid during the past few years. As far back as 1904 Mouret1 carried out systematic anatomic studies on the petrous pyramid. At that time he evidenced his understanding of infection of the petrous tip. He stated that "if the cellular arrangement favors an infection of the mastoid process in the presence of suppuration of the middle ear and facilitates the retention of pus in that part of the temporal bone, it is easy to understand how the pus can be extended into the perilabyrinthine cells and cause necrosis of the petrous pyramid."A series of 200 temporal bones were studied in 100 autopsies. These bones were studied in their normal position and relationship within the skull with the brain intact and also after they were excised. A better understanding of the cell groupings or arrangements of the petrous pyramid can be obtained by studying this part of the bone both in situ and after removal and by means of roentgenography and gross sections after removal. The cellular structure of both the mastoid and the petrous portions was noted. In addition dyes were introduced into the apex of the removed petrous bones to ascertain whether the dye would pass through one or more groups of cells. Sodium iodide and iodized poppy-seed oil 40 per cent were used with the roentgenographic studies but were found to be of no special value. The channels of pneumatization were further studied and in many instances recorded by means of photographs. The nerves and vessels in proximity to the petrous apex were studied. It was hoped thus to secure a better understanding of the various clinical pictures and syn¬ dromes which have been observed in involvement of the petrous pyramid as a complication of mastoiditis. At the same time various operations From the Department of Otolaryngology, Kings County Hospital. 1. Mouret, J.: Nouvelle recherches sur les cellules petreuses, Rev. hebd. de laryngol. 25:753 (Dec. 24) 1904. Downloaded From: http://archotol.jamanetwork.com/ by a Western University User on 06/09/2015

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