1. Local Anesthetic Injection

2. Tympanomeatal Flap

3. Elevate Annulus

4. Remove Scutum

5. Middle Ear Assessment

6. Incudostapedial Joint Separation

a. Downfracture Stapes Superstructure

7. Divide Stapedial Tendon and Posterior Crus

8. Harvest Perichondrium

9. Remove Stapes Footplate

10. Graft Placement

11. Prosthesis Placement

12. Closure

The evolution of stapes surgery for otosclerosis has undergone several advancements to reach its current form. Although the microscopic approach to stapes surgery  is still the current treatment standard for otosclerosis, endoscopic stapedectomy is a relatively new approach that has been gaining traction as a minimally invasive option. Endoscopic stapedectomy includes several important steps including incudostapedial joint separation, downfracture and removal of the stapes suprastructures, and prosthesis placement. These steps require a high level of technical skill and present a steep learning curve. However, this approach includes several technical advantages to decrease morbidity and support patient outcomes.  Here, we present the endoscopic approach to repair otosclerosis and ultimately improve conductive hearing loss. 

Watch this full-length, narrated surgical video of an endoscopic stapedectomy performed by Dr. Scott Brown at the Bascom Plamer Eye Institute.

DOI
Publication Date	2022/10/04
Article ID	308
Production ID	0308
Volume	2022
Issue	308
https://doi.org/10.24296/jomi/308

Endoscopic Stapedectomy

Procedure Outline

Table of Contents