Arch Otolaryngol. 1949;49(4):380-392. doi:10.1001/archotol.1949.03760100048003.
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IN JANUARY 1946 Popper1 brought out his "new, safer and less traumatic approach to the labyrinth—the transtympanic route." His technic offered such a striking simplification of the operation for otosclerosis as compared with previous methods that I decided to try it.

In the course of years, as is well known, the site of the labyrinthine fenestration has gradually shifted more and more forward from the lateral limb of the ampulla of the lateral semicircular canal to the ampulla itself and finally to the very roof of the vestibule, above the facial canal. In the employment of the Lempert operation, however, the transmastoidal route has been preserved. In this way the lateral semicircular canal is placed anteriorly in the operating field, it is true, but this technic is less suitable when it is desirable to place the fistula in the cupola of


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