At this stage of stapes mobilization surgery, it appears appropriate to evaluate some existing problems, and to consider some perspectives.
The two problems to be presented are the following:
The footplate approach
Delayed postoperative threshold shift.
A perspective which merits discussion is the question of combined myringoplasty and stapes mobilization in otosclerotics with tympanic deformities due to coexistent adhesive otitis.
I. The Footplate Approach
There has been a significant evolution in the modus operandi of the surgical technique of stapes mobilization since the first publication of Rosen,1 when he advised mobilization via the stapedial neck with a specially curved instrument. Shortly thereafter, others2-3 suggested force application through the lenticular process of the incus, through the capitulum of the stapes, and other modifications in the region of the incudostapedial joint. It was quite logical that initial attempts to mobilize the ankylosed stapedial footplate should begin at the
GOODHILL V. Stapes Mobilization—Problems and Perspectives. AMA Arch Otolaryngol. 1958;67(2):142–147. doi:10.1001/archotol.1958.00730010148002