Myringostapediopexy

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Abstract
In the course of performing modified radical mastoidectomy (atticomastoidectomy) on patients with attic cholesteatoma, I observed a number of instances in which serviceable preoperative hearing in the absence of the incus was accounted for by the pathological approximation of the posterior pars tensa against the stapes.1 In many such cases the upper part of the tympanic cavity was largely obliterated. However, there was always an inflatable air space extending from the Eustachian tube to the round window niche. The best air-conduction pure-tone threshold noted in such cases was at a 20 db. level. It occurred to me that a similar conduction-mechanism could be created surgically when the pathology was such as to necessitate removal of a portion of a functioning ossicular chain. In the past the surgeon in such instances had to compromise, either by incompletely removing the diseased area in order to preserve serviceable hearing or by removing

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