That which is offered in this paper is somewhat of the nature of a report on the progress of auralsurgery in a very important direction. Although not a new operation, the operation of excision of the membrana tympani and the two larger ossicula, as performed in this country, in thorough organization and elaboration, is new, and entirely due to the labors of Dr. Samuel Sexton, of New York. Excepting Dr. Sexton, Dr. Colles in New York, and myself in Philadelphia, are the only ones in this country who have performed the operation and published accounts of its performance.
The indications for the operation are:
1. The deafness, tinnitus and vertigo of otitis media catarrhalis chronica, especially when adhesions exist between the membrana tympani and the promontory, or there is evidence of synechiae between the ossicles.
2. The suppuration, deafness, tinnitus, vertigo, headache and recurring earache of otitis media purulenta chronica.