Fenestration in the Presence of A Mobile Stapes

Abstract

When, on the strength of past history and otoscopic, audiological and roentgenological findings, the diagnosis of otosclerosis has been established in a patient with complaints of hardness of hearing, a fenestration may be advised if a reasonable gain in hearing is to be expected from this operation. It is, however, impossible to say with certainty beforehand whether in these cases a fixated stapes will be found. It has repeatedly been described in the literature that a normally mobile stapes was found on operation.

A mobile stapes is sometimes found in patients subjected to a fenestration on the ground of the clinical diagnosis otosclerosis. In some cases the hardness of hearing is based on adhesive processes around the chain of auditory ossicles. Sometimes there is very probably an occlusion of the round window. In the first case a good result may be expected from the fenestration, but not so in the second case. An effort is made to explain this, based on some schematic considerations.

A suitable method is described for examining the function of the labyrinthine windows in patients under general anaesthesia.