Prevention of Complications in Stapes Surgery

Surgery for otosclerosis is simple in concept, yet good outcomes rely on successful execution of the fine details and the avoidance of complications. There are many descriptions of operative procedures for otosclerosis in the literature, including those by this author. These generally describe the basic elements of the operation in a sequential manner but do not focus on the particular critical points that are high risk for complications, nor do they describe how to avoid certain pitfalls. This chapter discusses the times during surgery in which the potential for complications is higher and proffers some thoughts on how to avoid them. Table 8 /1 considers the potential difficulties as well as some solutions. The procedure described here is the laser stapedotomy, which itself reduces the probability of complications relative to conventional stapedotomy. The reader is referred elsewhere for a description of the laser stapedotomy procedure and the basic procedural steps. This chapter focuses on specific areas of preparation and technique to avoid complications.