Large versus small fenestration technique in stapedectomy. A comparative investigation of House and Fisch prostheses in stapedectomy.

Sixty patients with otosclerosis have been operated on by 2 different techniques using either a small fenestra or a large fenestra. The hearing improvement by using a Fisch prosthesis (small fenestra) was significantly better in the high frequency range compared to results obtained by using a House prosthesis on a vein (large fenestra). Due to significantly better hearing in the higher frequencies the Fisch prosthesis is recommended. In technically difficult cases of stapedectomy, where extraction of the footplate is difficult or impossible the Fisch prosthesis can be valuable.