LSU surgeon describes procedure; Delicate ear operation restores micacle of sound to thousands

              An incredibly delicate operation performed under a microscope offers the miracle of sound to thousands who suffer from a mysterious disease affecting their hearing.
The disease is called otosclerosis. It is a hardening of bony tissue around the stapes, the key bone of the middle ear. This prevents transmission of $ound to the inner ear.
Some five million Americans are victims of otosclerosis. The cause of the disease is unknown. The new operation — called a stapedectomy — is successful in about 85 per cent of cases where the patient has sufficient function of the auditory nerve. Operations Here
A New Orleans otolaryngolo-gist, Dr. Harry Zoller, has performed a number of these operations in which the immobilized stapes is removed and replaced with a section of plastic tubing.
Dr. Zoller, associate professor of otolaryngology at Louisiana State university medical school, is enthusiastic about results of the operation.
The procedure, he said, is gaining broad acceptance among ear specialists all over the world.
"But the success of the operation/' Dr. Zoller cautions, "de-pends^ almost entirely on how good the function of the hearing nerve is. Chances Good
"If the hearing nerve is not seriously impaired, a stapedectomy offers a very good chance, that an otosclerosis victim can regain hearing in the affected car."
Persons with both ears affected often find that restoration of hearing in one of them is sufficient for all practical purposes.":
Beyond this, a stapedectomy frequently improves hearing in the opposite ear as well as the one operated on.
"You really need only one good ear to be able to hear," Dr. Zoller comments.
Elaborate Tests
The New Orleans surgeon conducts elaborate hearing and gpeech discrimination tests to determine if a prospective patient has a hearing nerve that is working well enough to warrant the operation.
Patients who can profit from the operation generally have good bone conduction (through the mastoid bone behind the ear).
Persons with normal hearing hear better through the ear than ^ through the bone. The opposite is true of otosclerosis victims. Dr. Zoller has had numbers ©f patients almost totally deaf in one ear whse hearing nerve functioned well enough for them to hear "at serviceable levels" after the stapedectomy operation. Microscope Needed
Ear  surgeons  must  use  an operating   microscope   to per-
form this delicate surgery because of the tiny area involved and the minute size of the stapes.
The stapes is about the size of an uncooked kernel of short-grain rice.
After a stapedectomy, it is very common for the operated ear to begin working properly as the patient recovers from sedation on the operating table. Usually, the patient stays in the hospital only two days.
The idea of loosening up the
gtapes when it became "frozen" by bony growth occurred to experts in the 1800s.. But the state of surgery then was too primitive to ensure success. Like Stirrup
The stapes — Latin for "stirrup," because it looks like one —is the final link in a series Of three bones which transmit vibrations from the ear dixim to the inner ear.
The other boenes linked to the stapes are the "hammer" ind the "anvil."
In otosclerosis, the stirrup bone is put out of action because its footplate — which fits in the "oval window" separating the middle ear from the inner ear — is immobilized
 bony growths.
Dr. Zoller's technique involves removing the stapes, footplate and all. Thus, he needs a replacement not only for the stapes but a covering for the oval window.' Vein From Hand
He gets this covering by cutting out a tiny section of vein from the back of the patient's hand. The piece of vein is slit open, scraped of its fat to thin it out, and stretched over the oval window.
A 31/2 Millimeter length of stiff polyethelene plastic tubing is then placed against the PHOTO: POINTING TO THE STIRRUP BONE on a large cutaway model of the human ear DR. HARRY ZOLLER shows patient T. V. EDWARDS of Ken-ner the area he worked on in restoring hearing in Edward's left ear, deaf for 15 years.