Techniques for otosclerosis surgery: Ear surgery from the microscope to the endoscope - A literature review

Abstract

Stapes surgery is the gold standard for managing otosclerosis. It has become increasingly appreciated to perform endoscopic ear surgery worldwide as the field of endoscopy expands. In basic terms, a stapes surgery intends to restore ossicular mobility and therefore improve sound energy transduction into the inner ear, thereby improving communication and sound amplification and bringing hearing levels back to acceptable levels. The aim of the study is to analyze surgical techniques comparing microscopic and endoscopic approaches for stapes surgery. The perspectives of Surgical Pioneers in Early Stapes Surgery and the contemporary development of surgical technology will be explored as well. Specifically, this study compiles well-documented, reliable information concerning the surgical outcomes for the endoscopic approach to stapes surgery and the results of recent studies.

Keywords: Endoscopic ear surgery; Learning curve; Stapedotomy.

Fig. 1

A. Various types of stapedial otosclerosis can be distinguished, including 1. anterior focus (most common): anterior to oval window, 2. posterior focus: behind oval window, 3. circumferential: affecting only the footplate margin, 4. biscuit type: preserving the margins while affecting only the footplate, and 5. obliterative: obliterating the entire oval window. B. Schematic coronal illustration of otosclerotic lesion C. Surgical placement of the otosclerotic prosthesis.