ABSTRACTThis is the last of a series of 4 articles detailing the history of 20 893 stapedectomies over an 18‐year period. In this fourth part, the authors study long‐term functional results in relation to the type of stapedectomy, the importance of the cochlear involvement and the general pathology, mainly vascular. They come to the conclusion that good long‐term functional results imply the necessity of combining a carefully performed stapedectomy using a living tissue graft, a strict audiometric surveillance and an adequate postoperative therapy, including (if necessary) an extensive fluoride th