Fenestration of the Labyrinth

The Lempert papers, and more particularly the address published in the Archives of Otolaryngology, January, 1945, have created a situation of some urgency to otologists. Claims that fenestration restores hearing in otosclerotic deafness have been established by various workers for the past seventy years from Kassel to Holmgren, Sourdille, Jenkins, Barany, Simson Hall and Lempert, to mention only a few. This aspect will not be discussed and readers are referred to the more recent publications. Lempert claims, and it would appear justifiably, to have triumphed over the main cause of failure—the osteogenetic closure of the fenestration after a few weeks or months by the insertion of a shaped cartilage into the newly created opening in the labyrinth. He further claims that his " mobile cartilaginous stopple " has banished another cause of defeat—post -operative labyrinthitis. Both the lapse of time and the clinical material at my disposal are insufficient for me to make an evaluation or to comment on these claims. The records of more than a thousand cases support Lempert in that a very large proportion of these had useful hearing restored—that is, such cases responded to airborne sound with an intensity of less than 30 decibels, and this improvement was maintained for a period of years. Simson Hall, although reporting on a vastly smaller number of cases, and adopting a more cautious attitude, reports 55 per cent, successful results.