# The quantitative and qualitative histomorphological structure of human stapes footplate

## TL;DR

This study provides a detailed analysis of the human stapes footplate's structure, offering insights to improve middle ear reconstructive surgery.

## Contribution

The first detailed qualitative and quantitative analysis of the stapes footplate's histomorphological structure.

## Key findings

- The stapes footplate has a bilayered bone-cartilage structure with increasing bone thickness toward the periphery.
- Central total thickness was 118.06 μm, increasing by 36% toward the periphery.
- Cross sections showed a more homogeneous distribution with 42% bone composition.

## Abstract

This study analyzes the histomorphology of human stapes footplates, focusing on the footplate (FP), to enhance reconstructive otosurgery. Seven human stapes specimens obtained during pathological dissections were histologically processed. Tissue layer thicknesses (bone and cartilage) were measured at five points in longitudinal sections and three points in cross sections. Additional analyses of surrounding tissue area up to 100 μm from each point were conducted. A total of 1400 individual measurements were included in the analysis of the human FP, comprising 350 measurements each for cartilage and bone layer thickness, as well as the determined cartilage and bone areas. The FP consisted of a flat epithelial layer, a bone layer facing the tympanic cavity, and a cartilage layer. The central total thickness was 118.06 μm, increasing by 36% toward the periphery. Bone composition was 40% centrally and larger peripherally at 56%. Cross sections showed more homogeneous distribution, with a total thickness of 73.44 μm and 42% bone. This first detailed qualitative and quantitative topographical tissue analysis of the FP confirms a bilayered bone-cartilage structure with increasing bone thickness toward the periphery. The findings provide critical insights into prosthetic coupling sites and support the development of optimized reconstructive strategies in middle ear surgery.

The online version contains supplementary material available at 10.1038/s41598-026-43700-8.