A FELLOWSHIP at Northwestern University in fenestration surgery under the supervision of Dr. Shambaugh was granted to one of us (Francisco) in 1947. When he returned to Spain the "Northwestern improved technique" was applied to approximately 100 fenestrations, with about 80% good results.
The success of the fenestration operation depends on the correct selection of cases and an exacting surgical technique to prevent osteogenic closure and postoperative serous labyrinthitis. Shambaugh's description of the ideal fenestra as one that is made "microimmaculate, enchondralized, periosteum-epidermis gloved, domed and burnished, with perfect asepsis and hemostasis" was a step forward toward complete success. Recently Lempert, after revising 100 fenestrations, advised invaginating the tympanomeatal flap into the fenestral gap and placing a small piece of cotton against it to facilitate healing of the flap with the fenestral margin to prevent osteogenesis.
In order to combine these ideas of two of the chief contributors to the