Extratemporal skeletal osteomyelitis is frequently encountered, and osteomyelitis of the diploic temporal bone furnishes no exception. We are cognizant of the fact that when osteomyelitis occurs in the temporal bone the otic capsule and the vestibular and cochlear portions of the auditory nerve may become directly involved. On the other hand, in general osteomyelitis other than that of the temporal bone the otic capsule and the auditory nerve may become secondarily involved by embolic phenomena or by contiguity or toxic absorption, thus creating the symptom complex of tinnitus, vertigo and deafness. When secondary embolic foci occur in the region of the otic capsule, continuity plays an important role in the causation of these symptoms. The symptoms vary according to the structures involved, the reaction of the patient to the osteomyelitic infection and the degree of toxic absorption. The incipient symptoms may be transient or permanent and may begin with tinnitus,