Impedance transfer: acoustic impedance of the annular ligament and stapedial tendon reconstruction in otosclerosis surgery.

The resistance rebuilt around the lower tip of the piston must be the same as that created by the annular ligament of the stapes footplate. Otherwise, the threshold at which an acoustic or barotrauma is able to damage the membranes and hair cells of the inner ear will be lowered. The elasticity reestablished around the lower tip of the piston plays a part in the quality and quantity of hearing for the low frequencies up to 3 kHz.

Survival and evolution of vein grafts in otosclerosis surgery: structural and ultrastructural evidence.

The annular ligament of the stapes footplate measures 0.2 mm2 and contains elastic fibers that restrict perilymphatic movement to a molecular level. This resistance of the annular ligament prevents excessive movement of labyrinthine fluids that are potentially hazardous to the membranous and cellular structures of the inner ear.

Stapedotomy: the JB Causse technique.

The Jean-Bernard Causse technique of stapedotomy, derived from Jean René Causse "Teflon-interposition" technique, offers an optimum reconstitution of the function of the annular ligament of the stapes footplate. The quantity and quality of hearing depend significantly, among other things, on the function of the stapes footplate annular ligament. Its impedance keeps the perilymph motion within a physiological acoustic amplitude quantum level unless the movements are so excessive as in barotrauma and acoustic trauma which would have overworked even the annular ligament of a normal footplate.