The relationship between the stapedial footplate and inner ear structures is very important.  The distance between the stapedial footplate and the saccule varies from 1.0 to 1.4 mm and from the footplate to the utricle varies from 0.7 to 1.4 mm.  In 25 specimens the shortest distance between the footplate and the saccule was 0.8 mm and between the footplate and the utricle was 0.38 mm.*  In patients with Meniere's Disease the endolymph is under high pressure and the membranes of the utricle and saccule are distended.  Sometimes they reach the footplate.  Stapedectomy in these patients is very hazardous and there is a high risk of postoperative deafness.

* Surgical Anatomy of The Temporal Bone and Ear.  Anson B.J. and Donaldson, J.A.  W.B. Saunders Company  p 282, 1973

   
Stapedectomy Surgical Technique: 
  
Stapes surgery involves removing the top part of the stapes and either removing all or placing a hole in the stapedial footplate.  This open the inner ear.  A prosthesis is then suspended from the long arm of the incus and placed though the footplate into the inner ear.  The attachment of the prosthesis to the incus is one of the hardest parts of the operation.  If the prosthesis is attached to loose, it may fall off.  If it is attached and the incus sustains too much trauma, the incus may die and the prosthesis will fall off.  Below are three new methods to aid in the attachment of the prosthesis to the incus.
  

View Video of Crimping a Prosthesis
with Hand Stable Instruments (1 min 52 secs).

  

View Video of Stapedectomy Technique
 using the Kurz Clip-On Prosthesis