In no field of otology is there so much confusion as in the treatment of neoplasms of the middle ear. The general attitude has been that radical mastoidectomy should be performed but that the outlook is hopeless and the patient doomed. The literature is scanty. The older literature refers to malignant growths of the middle ear as medical curiosities. Newhart 1 stated that he found reports of only 8 cases in the American literature. Keeler 2 in 1922 thoroughly reviewed the literature and compiled 60 instances and added 2 of his own. Since 1922, Barnes, 3 Furstenberg, 4 Lewis, 5 Burton 6 and Fraser 7 have presented reports of cases. INCIDENCE In the past twelve years 15 patients with neoplasms involving the middle ear were seen by the otologic staff of the Massachusetts Eye and Ear Infirmary. Three of these patients are now living—two, four and nine years, respectively,