The success of the laser STAMP procedure depends on the proper selection of patients. A candidate should have a blue footplate free of otosclerosis, except for the area adjacent to and involving the fissula ante fenestram. These characteristics can be assessed only at the time of surgery after entering the middle ear. Interestingly, it is difficult to predict candidacy based solely on preoperative audiogram. Rather, the patient is prepared for the possibility of laser STAMP versus conventional stapedotomy with prosthesis insertion. The surgeon should be prepared to do a stapedotomy with prosthesis, if the stapes is not completely mobilized after isolating the posterior two thirds of the stapes. If hearing should deteriorate in the future, the patient should be informed that a stapedotomy with prosthesis can be performed.
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