Transcanal Endoscopic Stapes Surgery: A Narrative Review

Stapes surgery has evolved from stapes mobilization to stapedotomy, which was initially performed using a surgical loop and is now done using an operating microscope. The improvement of endoscopic systems is attributed to the advancement of optical and medical engineering technologies, and has made endoscopic ear surgery a popular choice for various middle ear surgeries. In particular, endoscopic stapes surgery (ESS) has an advantage over the conventional microscopic stapes surgery (MSS) because it provides a wide-angled and magnified view of the middle ear structures, including the stapes, during surgery. All stapes surgical procedures can be performed exclusively using the transcanal endoscopic approach. Moreover, the postoperative hearing outcomes of ESS are comparable to those of conventional MSS. However, being a one-handed procedure with a steep learning curve, ESS can be an alternative to the conventional MSS, provided that the surgeon understands the advantages and disadvantages and is properly trained.