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To summarise our morphological findings of this study the following conclusions are drawn: In bone grafts growth of vital cells originating from the Haversian canals is clearly demonstrated. The growth of connective tissue in the Haversian system is understandable on general principles of pathology. The morphology of the change of osteocytes from fibrocytes through osteoblasts is photographically clearly shown and is in keeping with the findings of Steinbach and of Kerr and Smyth. New bone formation was detected at earliest nine months after implantation. Our investigations do not confirm whether this new bone formation occurs persistently in all cases or to what extent the original homograft material, preserves in cialit solution, takes part in this process. A similar mechanism of tissue regrowth should be accepted in homograft cartilage. We have studied two cases, one after 6 months and the other after 5 years following implant. The three fascial grafts examined compare with earlier publications, with oedema, slight inflammation and little shrinkage occurring. The suitability for grafting of homograft incus, cartilage and fascia we believe to have been demonstrated.

Results of follow-up examinations of 132 ears with serous or mucous middle ear effusions indicate that this disease is common in childhood and is also found in adults. In childhood adenoid growth as well as repeated catarrhal infection of the paranasal sinuses and the weakness of the levator palati play an important role in the development of middle ear effusions and deafness. With the aid of the operation microscope we were able to recognize this characteristic disease through the tympanic membrane. We perform regularly adenoidectomy together with paracentesis in this condition. In cases which had undergon several adenoidectomies we limit our treatment in the first instance to paracentesis. If cure is not so achieved we insert an inert tube into the tympanic membrane after the paracentesis. In persistent and difficult cases of glue ear radiation of the eustachion tube and antrotomy may be necessary.