Right revision otosclerosis surgery. Prosthesis dislocation is identified a beeing the cause of failure following previous stapes operation (other surgeon). The incus is intact. The previous technique was stapedotomy without interposition and a 0.6mm diameter Teflon piston was used. The loop of the piston appears dislocated from the incus which is intact and could be preserved. A new fenestration of the oval window is drilled out through the perilymph membrane followed by vein graft interposition and ossiculoplasty is made with a 0.4mm Teflon piston (incus-to-stapedotomy procedure). Dr Robert Vincent, Causse Ear Clinic, Béziers (Colombiers), France

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