Palpation of stapes for fixation; preliminary procedure to determine fenestration suitability in otosclerosis.

ONE CANNOT determine with absolute certainty if the stapes is completely fixed by any method except palpation of it with a probe during the fenestration operation. Pure-tone and speech audiometry tests have increased knowledge and predictability as to the result to be expected following fenestration for otosclerosis. The knowledge gained from these tests, however, is inferential and therefore limited as regards the degree of stapedial fixation present (partial or complete). Palpating the stapes to and fro, however, gives direct, firsthand sensory experience because one can see and feel the degree of mobility or its complete fixation. Such direct experimental knowledge is more reliable than the inferential diagnosis obtained by audiometry tests. A completely fixed stapes is pathognomonic of an otosclerosis condition which is ideal for treatment by fenestration, provided always that good cochlear nerve function is present. A partially fixed stapes in otosclerosis may not be as ideal for treatment