Introduction: Middle ear malformations are considered the main causes of hearing loss, and both the origins and the correlation of middle ear structures are not yet fully understood. Objectives and Methods: description of a tomographic study of a case of bilateral hearing loss. Results and Discussions: The study shows the absence of stapes with bilateral oval window atresia, associated with facial nerves with anomalous paths, medialized and positioned adjacent to the expected site for the oval windows. Conclusion: This study demonstrated a possible relationship between the embryogenesis of the stapes and its positioning in the proper formation of the oval window, as well as the correlation of these structures with the anatomical path of the facial nerve through the topography of the middle ear.
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