Endoscopic Otologic Surgery in Otosclerosis: A Retrospective Study at Avicenne Military Hospital, Marrakech

Objective: To evaluate the effectiveness, functional outcomes, and surgical advantages of endoscopic stapes surgery in patients with otosclerosis, based on a three-year experience at the Otolaryngology Department of Avicenne Military Hospital in Marrakech.

Materials and Methods: We conducted a retrospective study of patients operated on for otosclerosis between January 2020 and January 2023. All surgeries were performed using a transcanal endoscopic approach, involving a fully calibrated small-fenestra platinectomy and titanium prosthesis insertion, without the use of a surgical microscope. Patients were assessed pre- and postoperatively with audiometry (pure-tone average, air–bone gap), tympanometry, and postoperative functional evaluation.

Results: A total of 36 patients were included (28 women, 8 men; mean age: 38.5 years). Unilateral stapedotomy was performed in all cases, and no conversion to microscopic surgery was required. The mean preoperative air–bone gap (ABG) was 33 dB. At 3 months postoperative follow-up, closure of the ABG to <10 dB was achieved in 83%, with a mean postoperative ABG of 8.2 dB. No severe complications occurred; minor transient vertigo was reported in 14% of patients, and temporary taste disturbance (chorda tympani stretch) in 11%. No persistent tympanic perforations or sensorineural hearing losses were observed.

Conclusion: Endoscopic stapes surgery represents an efficient, safe, and minimally invasive alternative to traditional microscopic stapes surgery. Its advantages include wide-angle visualization, improved exposure of the oval window niche, and enhanced identification of anatomical variations. Based on our experience, endoscopic surgery offers excellent hearing outcomes and low complication rates, making it a valuable technique in modern otologic practice.