Stapedectomy. Postmortem findings.

Histological studies were made of 16 temporal bones of 13 subjects who had stapedectomy operations. Photographs of the prostheses in situ are a special feature of the studies. It was found that prostheses which overlap the margins of the oval window cause incomplete closure of the air-bone gaps. Fibrous adhesions were a common consequence of trauma to the mucous membrane of the middle ear. Gelfoam implantation promotes the formation of thin oval window membranes which tend to bulge out of the oval window. Most incudes show small areas of cortical bone resorption. In at least half the cases the surgical technique of stapedectomy, as judged from these studies, was less than ideal. Surgeons who perform stapedectomy should be cognizant of the relevant surgical pathology and adopt methods which will optimize functional results and minimize complications.