The first case of a primary mucocele of the petrous apex is presented and the differential diagnosis is briefly discussed. Since this area is unavailable for direct examination, a thorough radiographic evaluation is essential. A mucocele should be suspected when a lytic lesion has a multiloculated appearance and when the contralateral petrous apex is highly pneumatized. Even then, a biopsy may still be needed to make a definitive diagnosis. The appropriate treatment for these cystic lesions is fistulization into a radical mastoid cavity or an exteriorized sphenoid sinus.

Tetanus resulting from ear injury is extremely rare. However, the otologist should be aware that it does occur. A case of otogenic tetanus recently treated by the authors is presented.

In Western countries tetanus in now a rare disease because of extensive immunization programmes. Otogenic tetanus is extremely uncommon in North America, but occurs more frequently in tropical regions (De and De, 1970).

Less than forty new cases of tetanus are seen in the Province of Ontario (population, 8·4 million) each year (Department of Statistics, Government of Ontario).

It has been stated that the operative treatment of otogenic tetanus should include radical mastoidectomy (Black and Atkins, 1972). This is probably true in severe cases but milder cases do not require this form of therapy.

Most children in Canada receive primary immunization with Diphtheria, Tetanus and Pertussis vaccine (DTP) in the early years of life. However, especially in large urban centres, there is a large non-immunized or partially immunized immigrant population.

Tetanus occurring in such an immigrant is described.