Otosclerosis and Stapes Surgery Advances in Oto-Rhino-Laryngology

The article gives an overview of the historical development of stapedectomy beginning with Kessel in 1876. Then, from the beginning to the middle of the 20th century, surgery on the oval window became obsolete, opening the way for an era of fenestration operations until Shea in 1956 performed the first modern stapedectomy using a Teflon stapes replacement prosthesis. Since then, numerous surgeons worldwide have used this procedure with great success. Many of them have contributed towards progressively refining the surgical techniques, e.g. by changing the total removal of the footplate for the less traumatic small fenestra stapedectomy or stapedotomy. Copyright © 2007 S. Karger AG, Basel Early Attempts at the Surgical Treatment of Stapes Ankylosis The first description of a stapes ankylosis as the cause of hearing loss that has been passed down to us comes from Valsalva [1] from Bologna [2]. It is not known when the first attempts at stapes mobilization to improve hearing were carried out. A reference to this is to be found in Ménière, 1842 [3]. This is the description of a patient who was able to temporarily improve his hearing by tapping directly on the stapes with a small gold rod. Kessel (1876) from Graz, and later Jena [4, 5] is considered to be the actual founder of stapes surgery. On the basis of experimental investigations in the pigeon, he demonstrated that opening of the oval window did not necessarily result in destructive damage to the inner ear as was generally feared. He subsequently published a description of transtympanal stapes mobilization and stapedectomy as a method for the improvement of hearing in stapes ankylosis. The German otologists, Schwartze [6] and Lucae [7], also carried out stapes mobilization and removal of the stapes. In France, Miot [8] reported that he had achieved a hearing gain in Introduction