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• We present the pathologic features in the temporal bones of a 62-year-old woman with the adult benign form of osteopetrosis. Most of the bony tissue was expanded by dense lamellar bone, with, in some places, the presence of residual calcified cartilage. In the otic capsule, globuli interossei were greatly increased in number. The ossicles were enlarged with fixation of the stapes. Narrowing of mastoid air cells, the internal auditory meati, and eustachian tubes was present, the latter associated with chronic otitis media. The bone deposition in the ossicles contributed to the conductive hearing loss, which was a prominent feature in this patient's otologic findings. The narrowing of the internal auditory meati may similarly have contributed to a degree of sensorineural hearing loss. (Arch Otolaryngol Head Neck Surg. 1990;116:79-84)

To the Editor: Doctors Rius and Mendoza are to be congratulated on their persistence in theorizing on the etiology of otosclerosis. Examination of these four illustrations, however, would not convince this reader that they have been taken from otosclerotic cases. One must return to their 1961 article where the otosclerotic pathology is obvious. Figure 3 of that series is the same area as Fig 3 in this series. In both figures greater magnification would have been of value. One gains the impression from the earlier photograph that the "fat"-containing cells are really in the lamellar bone adjacent to the globuli. It would be physiologically plausible for bone cells to secrete a lipid. The mere presence of "fat" need not imply degeneration. Personally I do not find that otosclerosis arises primarily in the globuli interossei. These unique structures have a paucity of vascular supply and viable nuclei even in a 5-month

Congenital finger contracture occurs both as an isolated condition and as a familial one, although the latter is less frequent. In recent years, at least, no family group has been described, that presents this abnormality. Most of our knowledge on the subject of the familial type is based on observations on single or few members of one family. In the group described here, contracture has been frequent. A large number of those having the defect have been examined, and data concerning most of the remaining ones have been secured. The cause of congenital finger contracture has never been determined. The pathologic change underlying the contracture has long been a subject of dispute. The deformity has been attributed to flexor spasm, extensor paralysis, shortening of the volar skin, paralysis of the lumbrical and interossei muscles, shortening of the digital and palmar fascias, and shortening of the joint capsules. Neuhoff,1in

The subject of metatarsal arch disturbances is attaining the increasing importance it deserves. For a long period it was a general conception that nearly every condition occurring in this region was a "Morton's toe," named after the Philadelphian who described it in 1876. In 1889, Poullson of Lyons wrote on this subject. The term metatarsalgia, meaning pain in this region, is a symptom and does not describe the pathologic condition. The anatomy of the metatarsal region is very important. The skeleton of these parts consists of the metatarsal bases, shafts and heads. The proximal phalanges and sesamoids are accessory structures often closely allied to metatarsal disturbances. The metatarsophalangeal joints are simple ball and socket joints surrounded by capsules lined with synovial membrane. Like other joints, therefore, they are subject to stress, strain, injury, growth disturbance and infection. The muscles of this region are the plantar and dorsal interossei, the lumbricales

Experience with eight cases of immediate interossei decompression of the crushed hand showing impending ischemic contracture is described. Early intrinsic minus deformity and positive passive stretch test indicate interossei involvement and need for decompression of these unyielding canals to prevent the inevitable crippled hand. Excellent functional results in rapid time with early decompression have been the rule, and the procedure is recommended as part of the hand surgeon's treatment methods in preventing the crippling complications of the crush injury of the hand.