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March 9, 1957


Author Affiliations

Iowa City

From the Department of Otolaryngology and Maxillofacial Surgery, State University of Iowa College of Medicine.

JAMA. 1957;163(10):814-817. doi:10.1001/jama.1957.02970450016005

• Hearing impairment caused by otosclerosis was treated by mobilization of the stapes in 400 cases. The prospect of benefits from the operation was found to depend largely on the category of otosclerotic hearing defect. The category marked by normal bone conduction with more than 35 db. of loss in air conduction was twice as likely to be helped by fenestration as by stapes mobilization. The category marked by normal bone conduction and less than 35 db. of loss in air conduction was more likely to be helped by stapes mobilization. A third category, patients with a bone-conduction loss of not below the level of 30 db. with an additional air-conduction loss of at least 20 to 25 db., likewise had more favorable results from stapes mobilization. Fenestration is still the cornerstone of modern otosurgical procedures, and it is still needed to improve the hearing of many patients in whom the stapes mobilization procedure fails. But stapes mobilization fulfills a need for patients whose hearing losses do not fall within the levels necessary for successful fenestration, and it sometimes restores serviceable hearing when the nature of the hearing loss precludes such improvement by the use of fenestration.