Total or subtotal removal of the stapes footplate (stapedectomy) with tissue graft sealing of the oval window is still considered by many the safest surgical technique in otosclerotic deafness. However, Marquet and associates reported that a limited hole in the center of the footplate just large enough to admit a 0.6 mm Teflon piston is less likely to induce iatrogenic inner ear lesions and can result in better hearing in the higher frequencies than stapedectomy with vein graft interposition. Smyth and Hassard found that there was a significantly smaller incidence of fistula and immediate or delayed sensorineural hearing loss when a 0.3 mm Teflon piston in a 0.4 mm hole was used instead of standard stapedectomy techniques. They concluded that a small fenestra stapedectomy was the operation of choice.
© 1982, The American Journal of Otology, Inc.