The authors analyze five patients with different affections of the pyramid of the temporal bone - plasmocytoma, cholesteatoma, schwannoma of the VIIth and IXth nerve and glomus jugulare tumour. The symptoms persisted for 3 months to 15 years before establishment of the diagnosis. Impaired hearing, vertigo headache and lesions of the of the facial nerve predominated. For the diagnosis CT and NMR were the most important imaging methods. Except one patient all the others were treated by surgery - two patients by a transotic approach, one by a translabyrinthine and one by an intratemporal approach „A“. The authors emphasize the importance of imaging techniques for early detection of pyramidal lesions which may be manifested by a minimal symptomatology.

        Key words: lesions of the pyramidal apex, surgery.