Many years ago it was rather generally believed that the diagnosis of a malignant growth involving the middle ear once having been established, the prognosis was uniformly hopeless. Before the advent of modern radiotherapy and electrocoagulation the earlier literature abounds with reports such as those of Schwartze, 1 Toynbee, 2 Wilde, 3 Pomeroy 4 and others, who expressed the opinion that operation seemed to accelerate the rate of growth of the neoplasm. After this, there was an era characterized by reports such as those by Kretschmann 5 and others, who stated the belief that aural neoplasms should be operated on not because a cure could be effected but because relief of pain and diminution in the amount of foul-smelling discharge frequently resulted. The attitude toward the treatment of neoplasms involving the middle ear and mastoid bone has entered what may be termed a third stage, in which the conclusion has now been stated (by Holmgren, 6