Related Experiment Video
Updated: Jun 20, 2026
Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Round Window Drill-Out in Advanced Otosclerosis
Kaitlyn E Aragon1, Jeffrey T Vrabec2
1Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine.
Objective:
To discuss the effect of round window drill-out for otosclerosis cases with radiographic evidence of round window obliteration.
Patients:
Four adult patients (5 ears) were included with audiometric findings of a mixed hearing loss and radiographic evidence of otosclerosis causing round window obliteration.
Interventions:
Round window obliterative disease was addressed with a formal round window drill-out (RWD) by opening the lumen of the basal turn of the cochlea with a micro drill. The opening was then reconstructed with fascia to recreate a 2-window system.
Main Outcome Measures:
Feasibility, Δ pure-tone air conduction thresholds, and Δ pure-tone average air-bone gap (PTA-ABG).
Results:
Three (60%) ears underwent primary or revision stapedectomy with RWD, 1 (20%) ear underwent delayed RWD years after stapedectomy, and 1 (20%) ear underwent RWD without stapedectomy. Median preoperative PTA-ABG was 31.3 dB. One patient (2 ears) had significant benefit with PTA-ABG improvements of 45 dB (left) and 30 dB (right). Two patients (2 ears) had a small improvement in PTA-ABG (2.5 dB, 1.3 dB), whereas 1 patient (1 ear) had worsening in PTA-ABG (2.5 dB).
Conclusions:
Patients suffering from severe mixed hearing loss due to advanced otosclerosis may benefit from formal RWD to facilitate hearing aid use as an alternative to cochlear implantation.
