NO. 6 EAR EXOSTOSES HRDLICKA 37 



is practically never primarily involved by these abnormalities, though 

 it may be secondarily involved when the jx)sterior or anterior exostoses 

 are large and diffuse. 



In the old Egyptians of 4,000 years ago there is the same predomi- 

 nance of posterior growths, with a smaller proportion of anterior, and 

 no other. 



In the Polynesians conditions differ but slightly from those in the 

 Americans : there are somewhat less of posterior and correspondingly 

 more of anterior and antero-superior exostoses. 



The data demonstrate once more that, although there are some group 

 differences in the location of ear exostoses, this location discloses 

 certain general tendencies, which in their turn support the conception 

 of the process of these growths as a definite and separate abnormal 

 entity. 



Observation along this line on large numbers of specimens leaves a 

 strong impression of basic definiteness and rule, both as to location 

 and mode of development, which is radically opposed to any incidental 

 or purely local origin of these formations. 



SIZE 



In size the ear exostoses vary, according to Wyman (1874) from 

 " a pin's head to that of the whole caliber of the canal " ; according 

 to Whitney (1886), " from a simple thickening all stages can be 

 traced, up to the formation of round osseous growths as large as 

 pease, which in one or two cases have completely blocked up the 

 opening"; according to Russell (1900), from "minute nodule to 

 large tumorous growths". Sabroux (1901) says that their volume 

 varies much — from a simple protrusion on the walls of the canal to 

 a complete obliteration of the same. For Gray (1910) their size 

 ranges from " a pinhead to that of a bean ". Dahlstrom (1923) states 

 that they " seldom reach such a size that they would completely close 

 the meatus." Moller-Holst (1932) says that "the size varies from 

 that of a pinhead to exostoses that involve nearly one whole wall of 

 the meatus ; while in height they range from very low to those that 

 project up to 7 mm." There are additional statements on the point, 

 but they merely repeat more or less what has been given here. 



New observations. — From our observations, unimpeded by any soft 

 parts or wax or discharges, it is possible to state as follows : The 

 growths differ from small distinct abnormal bulgings or little circum- 

 scribed exostoses to bony tumors that almost occlude the meatus, or 

 even protrude beyond it. In no instance has an absolute occlusion of 

 the auditory canal been seen, but when in life the parts were covered 



