IT WAS pointed out by Holmgren1 in 1938 that in certain cases of otosclerosis the mobility of the malleus was either reduced or totally absent. Two parallel hairs inserted in a Siegle-Brüning speculum enabled him to judge the extent to which the handle of the malleus moves under compression and decompression. Holmgren reasoned that ankylosis of the stapes entailed reduced mobility of the incus, which in turn affected the incudomalleolar articulation, resulting in partial or total immobility of the shaft of the malleus.
Subsequently, Nager3 (1941) and his co-worker, Covell,2 (1940) established an anatomical foundation for this clinical observation. They examined 46 temporal bones with auditory ossicles from 31 cases of otosclerosis. Covell divided these 46 bones which showed otosclerotic changes into three groups. The first group included 15 bones with complete ankylosis of the stapes. The second group (16 bones) showed only partial ankylosis at the
MARSCHAK A. CHANGES IN THE AUDITORY OSSICLES IN OTOSCLEROSIS. AMA Arch Otolaryngol. 1954;59(5):566–570. doi:10.1001/archotol.1954.00710050578007
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