IRRIGATION OF OPEN VESTIBULE IN STAPES SURGERY. A CLINICAL AND EXPERIMENTAL STUDY.

Abstract

Postoperative cochlear loss and recession of hearing due to bony closure of the oval window are the two major problems in stapes surgery today, just as they were in the days of classical fenestration. Although most authors report a higher incidence of cochlear problems in total stapedectomy procedures than in those in which the vestibule is opened less widely, there is little agreement as to other factors responsible for cochlear losses in stapes surgery. Shambaugh and Takahara, 1 in a study in 1955 of cochlear pathology after fenestration, found a significantly higher incidence when bleeding into the fenestra was greater and when infection of the postoperative cavity was noted. House 2 noted an increase in the incidence of cochlear losses after stapes operations when organisms were cultured from the middle ear during surgery. He also suggested that the use of Gelfoam rather than tissue grafts to close the oval window