Conclusion

Stapedectomy, with reconstruction of the sound-conducting mechanism of the middle ear, is one of the most successful operations ever devised. It has stood the test of time, almost unchanged since it was first described in 1956.

Recently, measles virus invasion of the otic capsula has been implicated in the etiology of otosclerosis, in addition to the genetic tendency for this otosclerotic focus to occur in the fis-sula ante fenestrium region of the otic capsula. With measles vaccine inoculation almost universal in developed countries, we are likely to see much less otosclerosis in the future. Although the role of measles virus in the etiology of otosclerosis has not yet been fully explained, preliminary evidence is very convincing and, after all the facts are known, it should soon be accepted by everyone.

Now at the beginning of the twenty-first century, this most common and devastating cause of conductive hearing loss has been virtually eliminated by modern medical and surgical advances, measles vaccination, and stapedectomy with reconstruction of the sound-conducting mechanism of the middle ear. The profound hearing loss that afflicted Beethoven, Edison, and numerous less well-known people has been all but completely eliminated.

REFERENCES

Shea—CHAPTER 44

1. Kessel J. Über das Mobilisieren des Steigbügels durch Ausschneiden des Trommelfells, Hammers und Ambosses bei Undurchgängigkeit der Tube. Arch Ohrenh, 1878;13:69-88

2. Shea JJ, Jr. A personal history of stapedectomy. Am J Otol 1998; 19(suppl):S1-S12

3. Meltzer PE, Lindsay JR, Goodhill V, et al. Symposium. The operation for the mobilization of the stapes in otosclerotic deafness. Laryngoscope 1956;66:729-784

4. Shea JJ, Jr. Stapedectomy—a long-term report. Ann Otol Rhinol Laryngol 1982;91:516-520

5. Shea JJ, Jr. Eversion of the lining membrane of the vestibule. Laryngoscope 1974;84:1122-1134

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