EVER since it was first observed that the creation of an opening within the vestibular labyrinth in ears deafened as a result of stapedial footplate ankylosis in otosclerosis results in improved hearing, it became quite obvious that, whatever the physiology responsible for this phenomenon may be, the surgery is physiologically correct. Various theories were advanced to explain this physiological phenomenon. Let us examine how these theories stood up in the face of the observations made after this surgery.
In pioneering the surgery for otosclerosis, Holmgren1 advanced the perilymphdecompression theory in explanation of the hearing improvements following the fenestration operation. Sourdille,2 while subscribing to the perilymph-decompression theory, argued also that in order to obtain useful hearing following fenestration in otosclerosis the maintenance of the incus in its original position after removal of the head and neck of the malleus is absolutely essential.
In 19383 I advanced the theory
LEMPERT J. PHYSIOLOGY OF HEARING: What Have We Learned About It Following Fenestration Surgery? AMA Arch Otolaryngol. 1952;56(2):101–113. doi:10.1001/archotol.1952.00710020120001
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