Reducing footplate complications in small fenestra microdrill stapedotomy

Some surgeons have altered their technique for small fenestra stapedotomy in order to avoid footplate complications. This study aimed to determine what surgical step changes reduced footplate complications and improved hearing results. Operative reports provided data on surgical technique and complications in 151 consecutive primary stapes surgery patients. Comparisons of preoperative and postoperative audiograms provided hearing results of surgery. Fenestrating the footplate after, rather than before, stapes arch removal and fracturing the stapes arch after dividing one crus with a nipper were two surgical steps that reduced fractures. Hearing results were better after fenestration of the footplate with a microdrill compared to results with a hand drill.