MANIPULATION of the stapes in the oval window is not without risk to the integrity of the cochlea. Even greater risks are imposed when the stapes is removed and replaced with either viable grafts or nonviable materials such as absorbable gelatin, metal, or plastic. Great advances in audiosurgery in recent years have brought to the otosclerotic patient well-founded hope for dramatically improved hearing with the promise of lasting results. They have, however, brought also the realization of the vulnerability of the cochlea to the numerous procedures and implants to which it is subjected. Shambaugh1 has pointed out, "At the same time there has been a distressingly higher incidence of irreversible cochlear pathology producing further impaired and often useless ears."
Postoperative serous labyrinthitis following fenestration surgery had been previously noted by Shambaugh. Impaired hearing, diplacusis, reduced speech discrimination, vertigo, and nystagmus developed several hours postoperatively and persisted several days. Similar
Ginsberg IA. Cochlear Reaction Following StapedectomyA Comparison of Two Techniques. Arch Otolaryngol. 1968;88(5):481–490. doi:10.1001/archotol.1968.00770010483006