Suggested Readings

Shea—CHAPTER 44

Rosen S. Palpation of stapes for fixation: preliminary procedure Schuknecht HF. Stapedectomy. Boston: Little, Brown, and Co.; to determine fenestration suitability in otosclerosis. AMA Arch 1971 Otolaryngol 1952;56:610-615

Otosclerosis Management

CHAPTER 45

Karl L. Horn and Stuart G. Gherini

In 1958, John J. Shea, Jr., revived the long abandoned concept of stapedectomy for the surgical treatment of otosclerosis.1 Unlike Blake and Jack earlier in this century, Shea covered the opened oval window with connective tissue and reconstructed the impedance transfer of the ossicular chain with a polyethylene prosthesis from the incus to the oval window. Like the pioneering work of Lempert and Rosen, Shea's original surgical procedure was soon followed by many modifications of his technique. The common goal of all these subsequent stapes procedures is to restore the impedance transfer of the ossicular chain. Controversy for contemporary otosclerosis surgery is concerned primarily with the choice of surgical technique for bypassing the otosclerotic focus. It is our belief that there is no one correct way to perform stapes surgery for the treatment of otosclerotic stapes fixation. However, advances in instrumentation, particularly the introduction of microdrills and fiberoptic visible light laser hand pieces, have enabled surgeons to accomplish this goal in a more precise and delicate fashion.

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