Vestibular fenestration and stapedioplasty in congenital stapes and vestibular window abnormality.

In this paper the results of vestibular fenestration and stapedioplasty in cases of congenital stapes deformity and vestibular window abnormality are presented. The problems in the surgical reconstruction of the middle ear transmission system, especially the importance of the areal ratio between the tympanic membrane and the vestibular window and the ossicular lever action, are discussed. The following conclusions were reached: 1. The area of the new vestibular window should be greater than 2.0 x 1.0 mm, i.e., one third of normal. 2. Hearing gain was about 1.5 times better after incus-stapedioplasty than after malleus-stapedioplasty. It is recommended that an effort be made to adopt incus stapedioplasty whenever possible.