INTRODUCTION Primary melanomas of the temporal bone are rare. Two cases of malignant melanoma of the middle ear have been reported recently.Both of these cases were thought to arise from the mucous membrane lining the middle ear. Approximately 30% of all melanomas are found in the head and neck. The majority are cutaneous melanomas; however, mucosal melanomas are still a well-known entity. The temporal bone is a well-known site of metastatic involvement for many tumors, including melanoma. A search of the English-language literature reveals no cases of primary involvement of the petrous apex by melanoma.

Stimulation of the semicircular canals provides an alternative method of vibratory stimulation of the auditory system. The frequency response characteristics of stimulation of the tympanic membrane, malleus, stapes, round window, and fenestrated semicircular canal are presented in this article.

The recent demonstration of free-floating particles in the endolymph of the posterior semicircular canal in patients with benign paroxysmal positional vertigo (BPPV) has renewed interest in the physiology and treatment of this entity. The particle repositioning maneuver (PRM) relocates the free-floating particles from the posterior semicircular canal back into the utricle, relieving the patient of bothersome, often long-standing vertigo. This report represents a prospective study of 27 consecutive patients seen with a diagnosis of BPPV. Eighty-four percent of the patients treated with the particle repositioning maneuver who had no other associated pathology were cured or significantly improved with this new technique. Two patients who failed conservative management went on to surgical intervention with the posterior semicircular canal occlusion. The authors find the particle repositioning maneuver effective for many patients with benign positional vertigo and recommend it as the first-line treatment modality for BPPV.