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Updated: Dec 10, 2025

The Microscopic Transcanal Approach in Stapes Surgery Revisited
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Microdrill in endoscopic stapes surgery: Is it safe?

Vivian F Kaul1, Kevin Chow2, Santino Luigi Estrera1

  • 1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

American Journal of Otolaryngology
|August 28, 2020
PubMed
Summary
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Microdrill stapes surgery is safe and effective for both endoscopic and microscopic approaches in otosclerosis patients. This study found minimal differences in outcomes and costs, supporting its use in either surgical method.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Audiology

Background:

  • Stapes surgery is a common treatment for otosclerosis.
  • The microdrill is increasingly used in stapes surgery.
  • Concerns exist regarding the microdrill's depth perception in endoscopic approaches.

Purpose of the Study:

  • To compare the safety and efficacy of microdrill use in endoscopic versus microscopic stapes surgery.
  • To evaluate audiological outcomes, surgical costs, and complication rates for both approaches.

Main Methods:

  • Retrospective review of 29 adult patients with otosclerosis.
  • Patients underwent either transcanal endoscopic or microscopic stapedotomy using a microdrill.
  • Audiometric data, operative time, and complication rates were analyzed.
Keywords:
EndoscopeMicrodrillMicroscopeStapedotomyStapes

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Main Results:

  • No endoscopic surgeries required conversion to microscopic.
  • No statistically significant differences in audiometric outcomes (air pure-tone average, air-bone gap) between groups.
  • 82.8% overall air-bone gap closure to <15 dB, with similar rates in endoscopic (85.7%) and microscopic (80%) groups.
  • Endoscopic approach had a longer median operative time (51 min) compared to microscopic (42 min).

Conclusions:

  • Microdrill use in stapes surgery is a safe modality for both endoscopic and microscopic approaches.
  • The endoscopic approach with a microdrill demonstrates comparable outcomes to the microscopic approach.
  • Minimal differences in outcomes and costs support the microdrill's utility in either surgical technique.