Fenestration of the footplate of the stapes has been suggested as a routine step in the surgical rehabilitation of hearing to be used when other methods to mobilize the stapes have failed. Therefore, it should be carefully evaluated as to its potential ability to improve hearing and to the subsequent changes that may take place within the labyrinth.
The hearing improvement obtained by complete true mobilization or where part of the stapes footplate is mobilized in continuity with one intact crura has been shown to be valid by hundreds of surgeons. However, the results of the suggested "fenestra ovalis" technique for improving and maintaining hearing in otosclerosis should be reviewed.
One can in no way doubt the integrity of those proposing footplate fenestration,1 and indeed there is no reason to. The problem lies simply in the difficult determination of what really happens at the footplate in the large group