Increasing use of the stapes mobilization procedure has rapidly increased knowledge of variations in anatomy of the middle ear. Three such anomalies have been encountered by us and are here presented in detail. Review of the literature reveals few reports of such anatomical variations. Francis Sooy1reported bilateral absence of the incus in a 16-year-old girl. The hearing loss was a conductive type with 50 db. loss on the right and 45 on the left. Excellent improvement was produced by the fenestration procedure. Schuknecht and Trupiano2reported a case in which progressive hearing loss had occurred over a 12-year period. Bilateral conductive loss was found. Upon explora 2048 4096 8192 Fig. 1 (Case 1).— Preoperative audiogram.