Is small-fenestra stapedotomy a safer outpatient procedure than total stapedectomy?

We compared two stapedoplasty techniques to evaluate whether one technique is safer than the other as an outpatient procedure and to demonstrate possible reasons for outpatient failures. We performed a retrospective study of patient records of 94 operated adult patients who were all initially scheduled for outpatient surgery for otosclerosis (47 total stapedectomies and 47 small-fenestra stapedotomies). Six patients (13%) with stapedectomy and 1 patient (2%) with stapedotomy had to stay overnight at the hospital due to postoperative vertigo and nausea. The number of outpatient failures was statistically significantly different between the stapedoplasty techniques (p = 0.05). Five patients (11%) with stapedectomy and 2 patients (4%) with stapedotomy had a drop in bone conduction threshold between 5 and 8 dB pre- to postoperatively (n.s.). The short-term hearing improvement did not differ statistically significantly between the techniques when compared to the preoperative values. Small-fenestra stapedotomy is the safer procedure to be performed as outpatient setting than total stapedectomy.