Introduction.

Three topics are addressed in this supplement: the etiology and management of granulation tissue, the evolution of ototopical therapy, and strategies for avoiding topical ototoxicity.

I review the histopathologic origins of granulation tissue in the ear and the scientific evidence that supports the therapeutic effect of steroids.

Dr. Charles Myer, a pediatric otolaryngologist at the Children's Hospital Medical Center in Cincinnati, traces the evolution of ototopical therapy from the earliest times. He gives special attention to elucidating how to best select an ototopical antibiotic based on out scientific understanding of the characteristics of currently available drugs.

Finally, Dr. David Haynes, an otologist at Vanderbilt University Medical Center, addresses the increasingly worrisome issue of ototoxicity. Dr. Haynes reviews both the scientific data and the incidence and characteristics of clinical ototoxicity, along with the medicolegal implications of using a potentially ototoxic drop.

The purpose of this supplement is to provide clinically useful information to practicing physicians. I hope we have been successful.

Peter S. Roland, MD

Supplement Editor