THE SEARCH for the ideal surgical procedure in the treatment of otosclerosis which will restore the greatest initial and the greatest permanent improvement in hearing has inspired otologists the world over for the past seventy years. Shambaugh1 reviewed the developments which culminated in the Lempert one stage fenestration operation. The physiologic validity of creating a persistent bony fenestra in an ear with a good reservoir of cochlear function is evidenced by the large number of patients whose remarkable improvement has been maintained from one to eight years.
Investigation of patients whose improvement regressed in a few weeks or months has shown that failure is due to closure of the fenestra (bony or fibrous) or to postoperative membranous labyrinthitis. Experimental studies with monkeys (Shambaugh1) have supported these interpretations and revealed the pattern of bony regeneration and membranous labyrinthitis.
The different effects of labyrinthitis and fenestral closure may be illustrated by the
ROSEN S. CHORDA TYMPANI NERVE GRAFTII. Report of Follow-Up Observations One Year Postoperatively. Arch Otolaryngol. 1949;50(3):243–248. doi:10.1001/archotol.1949.00700010253001
Customize your JAMA Network experience by selecting one or more topics from the list below.