The role of stapedotomy techniques in predicting surgical outcomes
Reviewed by Madhup K Chaurasia

Several techniques have evolved in the surgery of stapedotomy for otosclerosis, especially with availability of laser. In this multicentre retrospective study, comprising 615 stapedotomies, the authors have compared three different methods: diode laser stapedotomy (group A), sole use of microdrill (group b) and microdrill combined with KTP laser (group C). Global audiometric results showed patient groups A and C to have better results than group B (microdrill alone) in one of the two statistical analyses applied, but not both. Comparison with some previous studies in the literature did not show this, probably because CO2 laser was used. Use of longer prosthesis (6 mm) showed better results than shorter ones (4.5–5 mm) in terms of ABG closure and AC gain. Careful measuring is therefore suggested. Results were also better with wider (0.6 mm) compared to narrower (0.4 mm) prosthesis, presumably due to better sound transmission. Secondary results showed no difference between use of fluoroplastic and titanium prosthesis. There were no differences in the rates of complications, including prosthesis displacement, transient facial weakness and footplate fracture, between the laser and microdrill techniques. The authors therefore contend that the pivotal factor is the size of the prosthesis, and that the choice of technique should depend on the surgeon’s skill and confidence.

Outcomes and predictive factors of success in stapes surgery: a multicentric retrospective analysis.
Bari MD, Sebastiani M, Alciato L, et al.
J LARYNGOL OTOL 
2026;140(2):214–20.