RESPONSE TO “SIMULTANEOUS TRUE STAPES FIXATION AND BILATERAL BONY DEHISCENCE BETWEEN THE INTERNAL CAROTID ARTERY AND THE APEX OF THE COCHLEA

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To the Editor: We thank the authors for their remarks, and we wholeheartedly agree that preoperative high-definition computed tomography is absolutely mandatory when contemplating stapes surgery. We have published an article emphasizing this matter in 2009 (1). The authors quite correctly point out that the vestibular aqueduct dehiscence because of a high-riding jugular bulb should be added to Table 1. We have indeed missed the articles by Hourani et al. (2) and Friedman et al. (3). We wish to apologize for this omission. The other articles the authors quote on this subject (4–6), although very pertinent to the case, could not have been mentioned in our publication because they were published after we submitted our article in January 2011. In all, we do of course concur with the authors’ conclusions. All these case reports clearly illustrate that what you see is not always what you get when the diagnosis of stapes fixation due to otosclerosis is made without adequate imaging techniques. As we have stated before: stapes surgery should never be attempted without ruling out a third window (5,6). Glen E. J. Forton, M.D., Ph.D. Department of Otolaryngology Head and Neck Surgery Heilig Hart General Hospital Roeselare Roeselare and Department of Neurosciences Faculty of Medicine University of Antwerp Antwerp, Belgium [email protected]

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