Small fenestra stapedotomy for management of progressive conductive deafness

Progressive conductive deafness may be caused by otosclerosis, a bone fixation of the stapes that causes reduced transmission of sound from the eardrum to the inner ear. Since the late 1950s, stapes surgery has been considered the treatment of choice for alleviating hearing loss due to otosclerosis. Over the past 20 years, there has been a decline in the number of stapes operations done. As a result, there are concerns regarding results of the stapes surgery done today compared with the results of such surgery when it was done more frequently. In this paper, I retrospectively review 603 stapes operations that I did at the Farrior Ear Clinic between 1981 and 1991. There were 484 primary stapes operations. Hearing results using the small fenestra technique showed closure of the air-bone gap to 10 dB or less in 96% of cases. During the same period, 119 revision operations were also done. The surgical technique, operative findings, and hearing results are presented. In both primary and revision stapes surgery, the hearing results of this series are compatible with the results of earlier, larger series. My findings show that stapes surgery is still the treatment of choice for hearing loss due to otosclerosis.