Stapes-pyramidal fixation with normal stapedius ligament is very rare. We present one casewith the stapes-pyramidal fixation with normal stapedius ligament in both ears. Stapes head and pyramidal bone were connected with a bony bar and stapes footplate was not scleroticbut mobile. Preoperative diagnosis was otosclerosis. At first operation, removal of the bony bar from the pyramidal bone using a chisel was attempted and consequently a total stapedectomy was resulted. The opposite ear has same stapes-pyramidal fixation by a bony bar with normal stapedius ligament.
Using SKEETER® drill (Medtronic XOMED, Inc.) only the bonybar was removed between the pyramidal bone and the stapes head, then stapes mobility was achieved. In each side of the ear the stapes showed monopodal superstructure.
