_The operation is contra-indicated_ if there is accompanying deafness, due to chronic middle-ear or to internal-ear disease, provided there is no suppuration within the external or middle ear. =Operation.= The method of operation depends on whether the stricture is membranous, fibrous, or bony in consistence, or whether it is limited or is causing a general narrowing of the auditory canal. It may take one of the following forms:-- _Dilatation._ This method is not very satisfactory, and is limited to recent cases of membranous or fibrous stricture of the annular variety. After cleansing the meatus, a small laminaria tent is inserted through the stricture, and if the pain is not too severe it is left _in situ_ for at least twenty-four hours and then withdrawn. The ear is again carefully cleansed, and if possible a larger laminaria tent is substituted. This procedure is repeated until the maximum amount of dilatation has been obtained. _Incision of the stricture._ This also is limited to membranous or to fibrous strictures of the annular variety. The operation, if necessary, may be performed under a local anæsthetic, produced by subcutaneous injections, although usually a general anæsthetic is preferable. The ear and surrounding parts are surgically cleansed by the ordinary methods. The surgeon works by reflected light. The patient may be in either the sitting or the recumbent position, depending on whether a local or general anæsthetic is given. In the latter case the auditory canal should be filled with cocaine and adrenalin solution before the anæsthetic is administered in order to diminish bleeding as far as possible. The ear having been dried, a conveniently large aural speculum is inserted, and with a tenotome or a furunculotome radiating incisions are made through the stricture. One of the small flaps thus made is grasped with a fine pair of tenaculum forceps, and the surgeon cuts through its base, keeping the knife as close as possible to the wall of the auditory canal. Each flap is treated in a similar fashion. Instead of making radiating incisions, the tissue forming the obstruction may be transfixed through its base, the knife being made to cut in a circular fashion right round the auditory canal, keeping as close as possible to its wall. On completion of the operation, a piece of india-rubber tubing, of as large a size as possible, is inserted into the dilated canal. It should only be removed for the purpose of cleansing and should be at once reinserted. A silver canula, if necessary, can afterwards replace the india-rubber tubing. This canula may have to be worn for months. This operation is often most unsatisfactory, as the stricture, instead of being annular as first supposed, may be found, on operation, to extend a considerable distance along the auditory canal and, in addition, to be partially due to a general thickening of the underlying bone.