468 stapes operations have been performed at the ENT-Department of the University of Zurich between 1970 and 1978. In one half of the cases, a total or partial removal of the footplate with introduction of a wire connective tissue prosthesis has been used. In the other half, the operation consisted in a limited fenestration of the footplate, which was large enough to accept a wire teflon piston of 0.6 mm diameter. Statistical analysis of the results of both methods shows a better bone conduction threshold for the speech frequencies (500, 1,000 and 2,000 Hz) as well as for air conduction at 4,000 cps after stapedotomy. Complete postoperative deafness occurred in one case following stapedectomy (0.3% of patients with primary operation). The advantages of stapedotomy over stapedectomy are the following: 1. Less trauma to the inner ear, 2. better stability of the position of the prosthesis and 3. better adaptation of the length of the prosthesis. The surgical steps used for stapedotomy are described.