Four hundred and twelve consecutive stapes operations for otosclerosis performed by the author were analyzed. A fat wire stapedectomy prosthesis (Schuknecht) was used in 160 cases and a Fisch Teflon wire piston in 252 ears. Ninety-four percent of the patients with a fat wire prosthesis had a closure within 10 dB and the remaining 6% one within 10-20 dB. As for patients with a Fisch Teflon wire piston, 85% had a closure within 10 dB, and 98-100% within 0-20 dB. Speech reception was better after the operation in 97% of patients with the fat wire prosthesis and in 99% of patients having the Teflon wire piston. There was a significantly different improvement in speech reception (p < 0.02) at the 20-dB level in favor of the Teflon wire piston. Our results show that the small fenestra technique with a 0.4-mm piston causes better speech reception at high frequencies.