Skull Base 2006; 16 - A047
DOI: 10.1055/s-2006-958581

History of Surgical Management of Otosclerosis

George Papacharalampous 1(presenter), Thomas Nikolopoulos 1, Sotirios Pappas 1, Olga Papadopoulou 1, Antonios Tzagaroulakis 1, Eleftherios Ferekidis 1
  • 1Athens, Greece

Aim: To review surgical attempts to correct the hearing loss associated with otosclerosis.

Methods: Literature search and medical history books were used as scientific sources.

Results: Many surgical attempts to mobilize or to remove the stapes were described at the end of the 19th century but the results were more or less unsatisfactory. The poor results were probably related to the lack of an operating microscope. Otologists switched their interest to the fenestration of lateral semicircular canal and Lempert in 1938 was the first who made the fenestration procedure familiar wordwide. Rosen in 1953 described a procedure to mobilize stapes. The results were very good but unfortunately temporary. An international debate between these techniques started in the late 1950s when Shea introduced stapedectomy with tissue coverage of the oval window. Later, stapedotomy (irrespective of the use of laser) became the most popular and widely used surgical method of management with lasting results and rare complications.

Conclusion: Despite the fact that many new surgical techniques have been described in the 20th century and many reconstruction materials and pistons have been developed, the basic principle of otosclerosis surgical treatment still relies on Shea's basic idea from the late 1950s. Stapedotomy, which is the evolution of Shea's concept, aims to restore the transmission mechanism to the oval window through a piston connecting the incus with a small oval window fenestra.