Analysis of the information obtained from more than 110 malformations of the external and middle ear operated upon by the author (Gerhardt) leads to speculation as to their course of development. Of particular interest are the varying types of stapes malformations and the influence of variations in the course of the facial nerve on the development and shaping of the stapes. In the light of clinical examples, an attempt was made to interpret the variations in the course of the facial nerve and certain forms of stapes and incus malformation on the basis of the developmental processes in the area of the skull base and of the brain.