Transcanal endoscopic stapedotomy

Transcanal endoscopic stapes surgery has recently been described as an alternative to the traditional microscopic procedure. The principal advantage cited by proponents of the endoscopic approach is improved visualization, whereas the primary limitation of the endoscopic approach is the need for one-handed surgery, which limits the ability to suction and provide retraction with the nondominant hand. The steps of an endoscopic stapedectomy or stapedotomy are generally no different than with a microscope, though it has been suggested that the endoscope reduces the need for bony removal of the posterosuperior canal wall and decreases manipulation of the chorda tympani nerve. Herein, we describe the perioperative workup and management, surgical technique, and published outcomes of endoscopic stapes surgery.