AVOIDANCE of trauma to the vestibular endo and perilymphatic structures constitutes the basic recommendation to be followed in stapedial surgery. Its accomplishment is reached if the surgeon takes a few things into account.
The first is to apply an aseptic and precise technique. This means that the operation has to be made according to a surgical routine that is achieved after adequate training and careful planning according to the surgeon's experience. Particularly at the level of the oval window this requirement is compulsory. The surgical procedure has to be very definite, neat, smooth, and effective in every single movement, resembling the techniques of prestidigitation. Repetition of movements is to be avoided while the instruments are to be kept as far as possible from the vestibular structures.
The second recommendation is to avoid surgical trauma. At first sight this is a repetition of the preceding statement. But we understand that
Romero-Diaz E. Stapedectomy Without Window Sealing. Arch Otolaryngol. 1969;89(6):807–808. doi:10.1001/archotol.1969.00770020809004
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