History of Otosclerosis and Stapes Surgery.

The current advancements in otosclerosis therapy cannot be fully appreciated without studying the history, rediscovery, and modification of a once-forgotten procedure. The evolution of stapes surgery can be best summarized into 4 noteworthy eras: the preantibiotic era (which was forgotten and then rediscovered), the fenestration era (mainstreamed by Julius Lempert), the mobilization era (led by Samuel Rosen), and the modern stapedectomy era (revived and revolutionized by John Shea). Each era is unique with its own challenges and ingenious techniques to overcome what used to be among the leading causes of deafness.

[Maurice Sourdille, otologist of Nantes, famous and unknown]. / Maurice Sourdille, otologiste nantais, célèbre et inconnu.

Fenestration was the first surgical operation to improve deaf persons affected by otosclerosis. Its story is on a par with Maurice Sourdille's. Not only this author had perfected this surgery even before the use of antibiotics and audiometry but he was a forerunner in the field of ear surgery and in medical otology.

The fenestration operation of Lempert: a historical perspective.

OBJECTIVE: To describe the events surrounding the introduction of the one-stage fenestration operation for otosclerosis and the presentation of the paper given to the American Otological Society in 1938. DATA SOURCES: Published data in scientific journals and news media, archival material from the New York Academy of Medicine and the John Q. Adams Center of The American Academy of Otolaryngology-Head and Neck Surgery, and a personal interview with the late Gordon D. Hoople, M.D. CONCLUSION: This article describes Dr. Gordon Hoople's exclusive account of the events surrounding the presentation of the first paper of the Lempert one-stage fenestration operation to the American Otological Society, why it was never published, why detailed proceedings of The Society were expunged from the record, and why Samuel J. Kopetzky was expelled from the American Otological Society.

Window on the ear: Barbara Hepworth and the fenestration series of drawings.

In November 1943, one of Barbara Hepworth's daughters (Sarah, one of triplets) developed osteomyelitis of the thigh. This necessitated operation and subsequent treatment at the Princess Elizabeth Orthopaedic Centre in Exeter by Mr. Norman Capener. Artist and surgeon subsequently became friends and she encouraged his activities as a 'weekend sculptor'. At his invitation she came to the hospital in November 1947 watching him in out-patients but more particularly in the operating theatre; other visits to London and Exeter followed. These studies of orthopaedic procedures form the great majority of Hepworth's sixty-plus hospital drawings/paintings but there is also a small group of six paintings involving an operation on the ear made in April and May 1948. The link between these two and the introduction to the ear surgeon, Mr Garnett Passe, is unclear. Five of the paintings of the ear operation are still in circulation but there is also a sketchbook containing no fewer than 28 drawings. A selection of the sketches together with the fenestration series of paintings will be discussed and also the relationship with the surgeon, Mr Garnett Passe.

[Juliusz Lempert (1890-1959): the author of the fenestration technique]. / Juliusz Lempert (1890-1958)--twórca fenestracji.

Juliusz Lempert was born in 1890 in Poland. A few years later the poor Jewish family emigrated to the United States. Lempert obtained his MD degree at Long Island Medical College, and soon after that established a small hospital of his own in Manhattan. Later he bought an old five-storey building and converted it into a new otological medical center, which he called Endaural Hospital. His life was rather difficult with the wave of antisemitism in the United States and the adversity which he encountered so many times. However his contribution to the microsurgical treatment of conductive deafness is immense. He elaborated and introduced a new method of mastoidectomy and, first of all, fenestration--a new one-stage surgical technique to be applied in cases of otosclerosis. This precise, sophisticated operation revolutionized surgical treatment. With a dentist's drill Lempert created a new window on the horizontal canal, in this way the sound wave could stimulate the inner ear. He was to call it "fenestration nov-ovalis". Lempert was never a member of any ENT society and worked in his hospital alone. When suddenly his only son was stricken with leukemia and died, Lempert was completely broken, and never returned to this work. The next blows were new operative methods of otosclerosis: stapes mobilisation introduced by Rosen and stapedectomy by Shea. He never accepted these new techniques. It was a painful experience for a surgical genius who had at so many times been hurt during his life. He could not believe that his fenestration was definitely gone. Lempert quickly deteriorated physically and mentally, and died in 1958.