Fenestration: a twenty-five-year evaluation.

A review was made at least 25 years after surgery on a series of patients who had been fenestrated for otosclerosis. Adequate follow-up information was obtained on 28 of the original 58 subjects. Of these three still had hearing above the social adequacy level of 30 db. HL. One half of the subjects had hearing that was still significantly better than it had been prior to surgery. Twenty-five years post-operatively more than half the patients were using hearing aids, generally with a high degree of satisfaction. Four out of five patients indicated that with hindsight they would still have gone ahead and had the operation. The small residual conductive impairment in a fenestrated ear appears to act as a protection against the effects of acoustic insult, in that the rate of decline of hearing with age in male subjects is less than the average for a normal population of adult males. The rate of decline approximates more closely with the assumed non-noise exposed female population.