growth of spongy bone in the wall of the inner ear so that it encroaches on the oval window—an opening in the wall of the bony labyrinth of the inner ear (this bony encroachment is called otosclerosis)—and prevents movement of the stapes, or stirrup, a small bone of the middle ear the base of which rests in the oval window. Normally, sound waves cause vibrations of the eardrum membrane that are transmitted by way of the malleus, incus, and stapes (three small bones in the middle ear) to the liquid in the inner ear; and these vibrations in turn affect the sensory cells in the inner ear. When the stapes is unable to move, a link in the transmission of sound waves is broken. Treatment of stirrup fixation is surgical and includes either creation of an artificial opening in the wall of the labyrinth (fenestration) or removal of the stapes with implacement of an artificial substitute, or both. Such an operation may not be feasible because of the extent of the otosclerosis or because of disease of the nerve or sensory cells of the inner ear.