Too many ears are made worse by stapedectomy. These ears are not able to withstand the considerable trauma of removing the stapes and surrounding otosclerotic bone (especially by drilling) and rebuilding the sound-conducting mechanism of the middle ear with vein and polyethylene, or fat and wire. Most important of all, these ears with extensive obliterative otosclerosis in the oval window usually have considerable otosclerotic invasion of the bone of the otic capsule surrounding the turns of the cochlea as well, with secondary deterioration of the supporting structures of the organ of Corti,1 as a result of which these ears are more "fragile" than they would be otherwise,2 and more prone to further or total sensorineural hearing loss when subjected to the considerable trauma of total stapedectomy. In the search for a more effective and safer operation for these ears with extensive obliterative otosclerosis, a new Teflon piston technique
SHEA JJ, SANABRIA F, SMYTH GDL. Teflon Piston Operation for Otosclerosis. Arch Otolaryngol. 1962;76(6):516–521. doi:10.1001/archotol.1962.00740050530006
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