Audiometric Evaluation of Stapes Mobilization Surgery

Abstract

Since Rosen's (10) reintroduction six years ago of a stapes mobilization procedure for the surgical treatment of clinical otosclerosis, many otologists have been utilizing the technique with encouraging results. As Philip E. Meltzer (7) has so dramatically phrased it, “This operation has fired the imagination of otologists throughout the world, and aroused in the mind of the layman a reaction burning with hope for the alleviation of deafness”.

The incidence of success, in terms of achieving the so-called “serviceable hearing level” of 20-30 db, still does not approach that of the Lempert fenestration procedure. However, as Goodman, Bilger, & Walsh (3) have shown, an unsuccessful surgical attempt at mobilization of the stapes does not preclude the fenestration approach, and many surgeons consider it favorably as a preliminary therapeutic step. In addition, stapes surgery is feasible in selected cases for which fenestration must be delayed because of the minimal extent of loss in the early stages of otosclerosis.

It is quite evident that stapes surgery is not a simple procedure when we consider the fragility of the structures involved, the extremely confined operative region, the need for magnification, and the difficulty of illumination for adequate visibility. The technique is still in a formative stage, one which the contribution of audiology is pertinent to evaluate properly any procedure in terms of final hearing results and selection of candidates. This paper represents an attempt toward such an evaluation.