[Piston-malleus. II (author's transl)].

The malleus appears to provide an effective solution in cases where the incus is absent and the upper part of the stapes cannot be employed, and when sound energy has to be retransmitted from the drum and the handle of the malleus to the labyrinth fluid. Total removal of the foot of the stapes with vein interposition is associated in nearly all cases. The method is not employed in patients with unfavorable positions of the ear-drum or handle of the malleus, the preferred procedure in the cases being the establishment of a direct communication between the ear-drum and the fenestra vestibuli, good results have been obtained.