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Although human stapes are known to have varied dimensions and the footplate is considered to be oval (fitting as it does into the oval window), few studies of high-resolution imaging of these structures have been performed. No study appears to have addressed the bilateral symmetry of stapes dimensions or to have determined if an association exists between the size of the stapes and the size of mastoid pneumatization; a small mastoid pneumatization is an indicator of childhood otitis media. We obtained 41 ear-normal cadaver crania specimens for study in our temporal bone laboratory and isolated 10 for further analysis: the 5 with the largest areas of mastoid pneumatization and the 5 with the smallest. Microcomputed tomography of tissue blocks was performed on the in situ stapes. Using Image} software, we created a three-dimensional model of each stapes. The mean height of these stapes was 3.43 mm (range: 3.20 to 3.80), the mean length of the footplates was 2.71 mm (range: 2.52 to 2.97), and the mean width of the footplates was 1.23 mm (range: 1.12 to 1.46). Qualitatively, the footplate was shaped like a human footprint in moist sand, as Eysell described in 1870. The dimensions o f the stapes were found to be bilaterally symmetrical in general, but there was no correlation between these dimensions and the size of mastoid pneumatization. The distribution of footplate widths may be bimodal, which is consistent with the observation of Sim et al that men have wider footplates than do women. [ABSTRACT FROM AUTHOR]