A surgical and anatomical classification using a polyethylene tube prosthesis in stapes surgery.

Abstract

The success of operative mobilization of the stapes for otosclerotic deafness depends upon restoration of sound conduction via the ossicular chain to the cochlea. The conductive impairment of sound in cases of otosclerosis is due to ankylosis of the stapes. In the past, improved hearing would result through surgery of the stapes only if the footplate were loosened and remained in continuity with the crura. This meant that there could not be a break in the transmission of sound from the tympanic membrane to the cochlea if improved hearing was to be obtained. Unfortunately, since the degree of stapes fixation and its anatomic structure vary, its delicate crura would separate from the footplate before it could be mobilized; thus, even if the footplate were mobilized, the gap in sound transmission prevented all possibility of improved hearing. This, briefly, was the reason for the operative failure in so many patients who