LXVIII Fenestration of the Oval Window

TLDR

Otosclerosis is a human‑specific metabolic disease marked by abnormal bone growth in the otic capsule that begins in late adolescence, often affecting the anterior footplate and oval window, and leads to hearing loss, with stapes ankylosis frequently recurring after surgery. The purpose of surgery in otosclerosis is to create a permanent passageway for sound from the middle to the inner ear. Fowler demonstrated that mobilizing the stapes can create a permanent sound passage.

Abstract

Otosclerosis is a compound metabolic disease characterized by the proliferation of abnormal bone in the otic capsule and hearing loss. It is unique to the human temporal bone. Basic Concepts of Surgery The proliferation usually begins in late adolescence, just anterior to the fissula ante fenestram, 1 continues for a number of years, and then stops. This proliferation follows a distinct pattern in that it is most frequently either confined to the anterior 30% of the footplate and oval window or widespread throughout the footplate and surrounding oval window. The purpose of surgery in otosclerosis is to create a permanent passageway for sound—from the middle to the inner ear—once again. The entire stapes can be mobilized at surgery in a large percentage of cases by various means, but the basic pathology remains essentially unchanged and all too often ankylosis of the stapes recurs. It has been demonstrated by Fowler