Operation was carried out on 34 patients (38 ears) with congenital atresia of the external audiotory canal. Among these audiogram was accurately recorded before and after operation in 9 ears receiving Pattee's operation, 8 ears receiving Wullstein I and 9 ears receiving Wullstein III. Only 7 ears reached within 30 db in practical speech frequencies. The results obtained by Wullstein I (3 ears) proved to be poor, and the reason for this phenomenon was pursued with the otoscope and Schall's sound. It was noted that even in the cases in whom both the malleus and incus were mobile and in whom subjective hearing had improved during operation, there were some not showing improvement of hearing after operation because of dissociation of the incus-stapes article or hypoplasia. By hypoplasia here means no formation of article although the crus longum ofincus and capitulum of stapes are located adjacent to each other. Sound cannot be fully transmitted under such conditions. In the literature such a report has never been reported excepting for Hough's paper on this subject.
Tracheotomy has been hitherto used as a method for temporarily treating dyspnoe or for removing foreign body from the respiratory tract. With recent advances in brain surgery and chest surgery and with the increase in number of brain and chest injury, the application of this method has been increasing. Injury of the brain caused by surgery or trauma influences the respiratory center and causes a drop in its function. At the same time there is a drop or disappearance of cough reflex, and this leads to the accumulation of secretory substance in the bronchi which disturbs the O2 and CO2 exchange. Tracheotomy carried out under such conditions gives favorable results.
The case is that of a 17 years old Japanese female who due to a giant cystic craniopharyngioma demonstrated various symptoms, pituitary dwarfism and secondary sexual characteristics. A vinyl tube was inserted through the nose into the lesion and an attempt was made to remove the cystic content. This lead to the disappearance of headache, convulsions, incontinence and vomiting and she took a relatively fair clinical course thereafter.