The Fenestration Steps of Stapedotomy

Aim: The purpose of this project is to offer information to those who are interested in the possibilities of avoiding acoustic damage during the surgical performance of otosclerosis using the method of fenestration of the stapes' base. Method: We present the following chapters: local anesthesia; the endomeatal incisions, tympanotomy, and the exposure of the middle ear cavity; the exposure of the middle ear elements; exploration and forward mobilization of the chorda tympani; laser surgery: (1) the use of laser in the stapes; (2) techniques of the fenestration of the stapes' footplate; (3) the use of CO2 laser to create fenestration in the center of the stapes' footplate; (4) fenestration of the footplate by use of a straight needle; (5) techniques of replacement of the piston prosthesis; (6) complications of the fenestration on the stapes footplate. Results and Conclusions: We believe that this manual describing alternative techniques of surgical steps, movements, and instruments is useful for a thorough didactical update on better treatment in cases of chronic otitis media.