=Operation.= The procedure is the same as for the removal of exostoses (see p. 318). After separating the fibrous from the bony portion of the canal, an incision is made through it and the cut edges are held aside with forceps. Usually the foreign body can now be seen lying within the canal. It is best removed by passing a small fenestrated curette beyond it and levering it out. In some cases one of the hooks already mentioned will be found to be more suitable. Forceps should not be used, as they may inadvertently push the foreign body farther in. If the foreign body be very deeply placed, removal of the upper posterior portion of the bony meatus may be necessary. The subsequent steps of the operation and its after-treatment are similar to that already described in the case of an exostosis. =By means of an operation upon the mastoid.= =Indications.= (i) If the above measures fail to remove the foreign body. (ii) If there be symptoms of inflammation of the mastoid process, or of internal-ear or of intracranial suppuration. (iii) If there be facial nerve paralysis the result of pressure from the foreign body. =Operation.= The operation performed depends on the condition found. Simple opening of the mastoid antrum may be sufficient in a case of recent middle-ear suppuration, although it is usually necessary also to remove a considerable portion of the posterior wall of the auditory canal before the foreign body can be extracted. If these measures fail, an attempt may be made to dislodge the foreign body by forcibly syringing through the aditus, or by the insertion of a probe through it, into the tympanic cavity. If this likewise ends in failure, it will then be necessary to perform the complete operation. These cases fortunately are rare. If it be certain that chronic middle-ear suppuration already exists, the complete mastoid operation is indicated. If it becomes necessary to operate on the mastoid process, owing to other means having failed to dislodge the foreign body, it is wiser, as a rule, to perform the complete operation at once, because, under these circumstances, irreparable destruction must have taken place within the tympanic cavity. The technique of these operations and their after-treatment are described in the chapter on operations upon the mastoid process (see p. 390). OPERATIONS FOR STENOSIS OF THE EXTERNAL MEATUS Stenosis, or stricture of the auditory canal, is practically always the result of traumatism or inflammatory conditions; it is only very rarely congenital. =Indications.= (i) If there be deafness of the other ear, and the functionally good ear periodically becomes deaf from obstruction of the narrow passage by cerumen or epithelial débris, and the patient is weary of conservative treatment. (ii) If there be recurrent attacks of otitis externa. (iii) If there be retention of pus, the result of inflammation of the external or middle ear, which is not relieved by conservative treatment.