Using a new otologic database, our series confirms that stapedotomy with vein graft interposition for otosclerotic stapes fixation is a safe and successful treatment for long-term hearing improvement. The deterioration in hearing with time after stapedotomy did not exceed the rate of hearing loss because of presbyacusis. Therefore, argon laser stapedotomy with vein graft interposition is our preferred surgical technique in the treatment of otosclerosis. Obliterative otosclerosis and simultaneous malleus ankylosis may be encountered during stapedotomy. Our study shows that reasonable success rates can still be expected in these situations. Stapedotomy results in the elderly and in children are comparable to those obtained in patients of other groups of age undergoing surgery for otosclerosis without an increased risk for complications.

Epidermoids consist of epidermal and connective tissue structures usually in the form ofa sac. They have the capacity for independent progressive growth often at the expense of neighbouring bone and have a tendency to reform after removal. The sac is lined by stratified squamous epithelium and contains epithelial debris.Epidermoids are uncommon lesions of the central nervous system.`'-The cerebellopontine angle is the most common site of occurrence of intracranial epidermoids,45 and account for 9% of tumours in the cerebellopontine angle, second only to acoustic neuromas. Other reported sites include the optic chiasma, diploe of the skull and the posterior fossa. We report experience with the behaviour and management of 30 epidermoids of the cerebellopontine angle seen over a period of 20 years. We also briefly describe a previously unreported surgical technique employed during the excision of these lesions which involved the use of the operating microscope and bipolar diathermy for the cauterisation of epithelial remnants to minimise reformation of the epidermoid.

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Most patients with Chiari I malformation have symptoms that mimic primary otologic pathologic changes. The existence of common pathophysiologic mechanisms is proposed.

This study shows that safe and successful stapedotomy is possible in cases of stapes fixation in patients with osteogenesis imperfecta.