RNs in the most neutral way, and themselves in between at all three stages. This finding tended to become even more pronounced over time. The two characteristics which emerge as most intense for all three occupations at all stages of the study are intelligence and competence. These findings suggest that the PA holds a positive image of the medical team members with whom he interacts. The attitude noted indicates that continued effective team work is highly probable and not likely to detract from the quality of service rendered. It should be kept in mind, however, that the nature of this research has been preliminary, and long-term conclusions must await further study. Abstract: A pure tone air conduction audiometric evaluation was administered to 137 dentists and 80 physicians. The physicians were found to have better hearing threshold levels, notably in the 4000Hz center frequency range. The left ear of right handed dentists showed a greater loss of hearing ostensibly related to proximity to the noise source. Dental specialists showed a loss pattern similar to those of the general dentists. The findings suggest that there may be a cause and effect relationship between hearing loss and use of the highspeed dental handpiece. (Am J Public Health 70:633-635, 1980.) Ever since the development and use of the air driven high speed dental handpiece some 25 years ago, concern has been expressed and reported in the literature of a possible cause and effect relationship between use of the drill and loss of hearing in dentists. Previous studies have noted the existence of complaints of tinnitus, and a few have shown some minimal degree of high frequency sensorineural loss, dis-

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Congenital middle ear choleslcatomas remain of interest because of their relative rarity and unknown origin. A 4‐month‐old child presenting with bilateral congenital middle ear cholestcatomas forms the basis for this report. The nature of the epithelial debris found suggests an external origin. An extended transcanal tympanotomy approach for removal, based upon an operative experience of 11 similar ears, will be discussed.