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Updated: Jun 2, 2026
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The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Laser stapedotomy minus prosthesis: long-term follow-up
Herbert Silverstein1, Mark J Van Ess, Yadiel A Alameda
1Ear Research Foundation and Silverstein Institute, Sarasota, Florida 34239, USA. hsilverste@aol.com
Summary
Laser stapedotomy minus prosthesis (laser STAMP) offers stable, long-term hearing improvement for otosclerosis patients. Proper patient selection is key for this minimally invasive procedure to preserve stapes anatomy and achieve lasting results.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Devices
Background:
- Otosclerosis, a condition affecting the stapes bone, often leads to hearing loss.
- Traditional stapedotomy procedures carry risks and may not always yield optimal long-term hearing outcomes.
- Laser stapedotomy minus prosthesis (laser STAMP) presents a minimally invasive alternative for otosclerosis treatment.
Purpose of the Study:
- To evaluate the long-term hearing results and efficacy of the laser stapedotomy minus prosthesis (laser STAMP) procedure.
- To assess the stability of hearing improvement and the incidence of complications following laser STAMP.
- To identify factors influencing the success of laser STAMP in patients with otosclerosis.
Main Methods:
- A retrospective case series involving chart review of 74 adult patients (77 ears) who underwent primary laser STAMP for otosclerosis.
- Data collection included pure-tone air and bone conduction thresholds, and word discrimination scores preoperatively and at regular follow-up intervals.
- Minimum one-year follow-up data were analyzed for hearing outcomes and surgical revisions.
Main Results:
- The average air-bone gap (ABG) improved significantly from 23 dB preoperatively to 6 dB at 6 weeks postoperatively, and remained stable at 7 dB at a median of 33 months.
- A low rate of revision surgery was observed (9%), with refixation noted in 4% of patients, indicating good long-term stability.
- The procedure demonstrated preservation of stapes anatomy and stable high-frequency hearing improvement.
Conclusions:
- Laser STAMP is a safe and effective minimally invasive surgical option for treating otosclerosis, providing stable long-term hearing gains.
- Careful patient selection, focusing on accessible anatomy and otosclerosis confined to the fissula ante fenestram, is crucial for successful outcomes.
- The procedure offers advantages such as preservation of stapes anatomy and durable high-frequency hearing improvement.
