Proceedings of the Round Table Discussion on the Fifth International Symposium on Otosclerosis and Stapes Surgery.

Background Debates and research about otosclerosis and stapes surgery have continued since the time it was described, and there is still no consensus on many issues. The aim of this article is to report the controversies in the etiology, pathophysiology, diagnosis, imaging, treatment, and management of otosclerosis and address the points of consensus of experts.Methods In the last session of the Fifth International Otosclerosis and Stapes Surgery Symposium held in Brussels, a round table meeting was held where controversial issues in otosclerosis and stapes surgery were discussed, and a survey was administered to all participants. Nine experienced panelists were interviewed by the moderator on stage, and 166 participants provided their answers interactively through the online voting system.Results All of the panelists were experts in their field who had performed more than 1000 cases, and if we take into account the more experienced participants, the results are based on at least 16 968 stapes surgery experiences. While full consensus was reached by the expert panelists on 14 questions, agreement was reached by participants on only 2. The most striking difference between the panelists and attendees was regarding reparative granuloma.Conclusion Even if a consensus was reached on some issues, controversies, especially the surgical technique, medical equipment and prostheses used are subjects to both discussion and development. Even the experts who come to present and share knowledge do not always agree. It is strongly recommended that clinicians follow all developments, compare their results with those of others, and use the techniques and materials with which they feel most comfortable for their patients.