Stapedectomy--past and present.

Surgical technics for bypassing ankylosis of the stapes in the management of otosclerosis gradually evolved; modifications were prompted by problems which were revealed by the ongoing audits carried out by earlier surgeons. Auditing of performance must remain an integral part of any otologist's work. The natural history of otosclerosis should be taken into account so that a patient may be fully informed of treatment alternatives available. Stapedectomy will remain a most effective operation which can be recommended with confidence, provided the surgeon has acquired the skill to perform it properly. It is now accepted that many ear, nose and throat surgeons are neither physically nor temperamentally capable of this task and should not perform stapedectomy.