Abstract

The thesis of this article is that there are specific pathological indications for each of the varied types of operations upon the stapes, the oval window, and the ampulla of the horizontal semicircular canal. The purpose of this article is to describe these specific anatomical and pathological indications for the varied operations which are as follows: The direct attack on the otosclerosis itself,<sup>1-3</sup>at the anterior footplate, is indicated only in very thin otosclerosis with fixation limited to the level of the footplate, and when the crura stand free in the middle ear. The original indirect attacks on the incus, head, or neck of the stapes<sup>4-8</sup>is now indicated only in footplate otosclerosis when the stapes is deeply placed in the oval window niche. Anterior crurotomy<sup>9</sup>and mobilization and impaction of the posterior half of the stapes is indicated in the thicker anterior lesions which fix the

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