Abstract
The endaural operation has been chiefly used for chronic aural suppuration, and the majority of writers on the subject have refused to recommend it for acute aural suppuration. Even those who have made the greatest use of it (Thies and Thies1; Guns2; Bockstein3) and have not hesitated to use it in more complicated cases have refused categorically to perform it for acute mastoiditis. The grounds for this are anatomic (Rejtö4; Neer5), clinical (Staunton Wishart6; Babbit7) and surgical (von Eicken8; Pruvot9). The great difference between chronic and acute aural suppuration has been stressed by many. A résumé of these differences follows: In chronic otitis the mastoid is mostly sclerotic and the disease is more concentrated around the antrum and the tympanic cavity. The operation requires removal of the posterior wall of the aural canal and plastic use of tissue from the external auditory meatus. In acute mastoiditis there are other circumstances.

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