The fenestration operation for improving the hearing in otosclerosis rests on a very simple principle: the creation of a new window into the labyrinth to take the place of the oval window which has become occluded by the otosclerotic bone proliferation.
The history of the fenestration operation is the story of the search for a method of making a labyrinthine fistula that will remain open. The essentially international character of science is exemplified in this search. Passow in Germany in 1896 first made a new opening into the labyrinth in a case of otosclerosis, but the hearing improvement lasted only a few days. Jenkins in England, Bárány in Vienna and Holmgren in Sweden successively attacked the problem, but invariably the hearing improvement was of brief duration as new bone formation closed the labyrinthine fistula within a few weeks or months. Engstrom,1 working with Holmgren in Sweden, carried out extensive