The Fenestration Era
Otosclerosis is a fairly common disease, being found, histologically, in 10% of the human temporal bones. But the abnormal bone formation that characterizes the disease causes hearing losses in only one tenth of the persons that have inherited the disease, which means that only 1% of the population has hearing loss caused by otosclerosis. What happens in these persons is that the stapes is fixed by the abnormal bone formation, causing what we call a conductive deafness. The person does not hear well because a significant part of the sound energy does not reach the receptor cells of the inner ear. It is like the cataract in the eye: the opaque lens does not allow all of the light to reach the receptor cells in the retina. The stapes fixation was described by Valsalva in 1704. A famous English otologist, Joseph Toynbee, made a detailed description the stapes fixation in 1841, but felt that this was caused by infections. It remained for Adam Politzer to describe the histologic feature