In all audiosurgical systems the sound wave is guided directly toward the oval window or toward the fenestra created as a substitute for it. The round window takes upon itself the part of a passive window shutter, being protected for this purpose by a pneumatic space which is ventilated through the Eustachian tube.
This behavior is fully justified in those audiosurgical systems in which the transformer mechanism of the middle ear is preserved (tympanoplasties with complete reconstruction, columellizations, mobilizations with a complete, continuous ossicular chain).
However, when the transformer mechanism of the middle ear is destroyed by lesions or annulled by the surgical act (tympanoplasties with a small hypotympanic space, typical fenestrations, surgery vulnerating the oval window, as by Cornelli, Herberts, Guillón, and "fenestra ovalis" by Rosen) there is no reason forcing the surgeon to channel the sound always onto the oval window, since, under such circumstances, the sound wave
GARCIA-IBANEZ L. Sonoinversion: A New Audiosurgical System. Arch Otolaryngol. 1961;73(3):268–272. doi:10.1001/archotol.1961.00740020276004
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