74 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 93 



to such a possible connection in the earher Hterature. Alexander 

 (1930, p. 456) believes some of the growths to "be connected with 

 general constitutional diseases ", but does not specify or go further 

 into the subject. 



INNERVATION 



Toynbee's (i860) class II of ear exostoses "showed symptoms 

 indicative of diseases in the cavities containing the expansion of the 

 auditory nerve." 



CONNECTION WITH EXOSTOSES OF INNER EAR, OR OF OTHER PARTS OF THE SKELETON 



A connection of meatal exostoses with those of the inner ear was 

 noted by Toynbee, Gruber, Schmaltz. Virchow (1889) saw that in 

 two of his cases the skeleton showed also other exostoses, which sug- 

 gested a possible connection. Krakauer (1891) was inclined to 

 believe that there was a connection between meatal exostoses and 

 multiple exostoses of the skull. Ostmann (1894) believed the ear 

 exostoses to be due in part to " a tendency to excessive bone produc- 

 tion, such as manifested through multiple exostoses." 



OTOSCLEROSIS 



Burton (1927) attempts to identify the process leading to ear 

 exostoses with otosclerosis. Bezold ( 1895, P- 5^) states that " sclerotic 

 processes in the middle ear do not infrequently coexist with the 

 exostoses." 



Rafin and Rougier (q. by Sabroux, p. 22) cite a case of advanced 

 obliteration of the auditory canal by exostoses, in which the mastoids 

 were more developed than the average; Knapp (1898) looked upon 

 some of the ear exostoses — because they are so often posterior — as 

 probably due to primary affections of the mastoid. 



MASTICATION 



Burton (1927) raises a point which, curiously, has been neglected 

 b}' other authors. This is the influence upon the meatus of the ac- 

 tivity of the lower jaw. He believes " irritation to the aural canal due 

 to mastication to be a contributory factor of aural exostosis." The 

 excess of the growths in the male he attributes to the same factor. 

 But Moller-Holst (1932, p. 102) says the idea of the effect of masti- 

 cation cannot be sustained. 



