Laser stapedotomy minus prosthesis (STAMP) surgery can be accomplished without the insertion of a prosthesis.19 An otosclerotic focus limited to the anterior third of the footplate may be managed by laser vaporization of the anterior crus and division of the stapes footplate between the anterior one third and posterior two thirds, making a transverse linear laser cut. These cuts release the posterior footplate and posterior crus, obviating the need for prosthesis. The procedure differs from previously described mobilization techniques that created a fracture through the otosclerotic focus and failed due to subsequent refixation. Division of the stapes footplate posterior to the otosclerotic focus can provide lasting air-bone gap closure.19 21 The anterior crus and anterior footplate are rarely fully visualized using the operating microscope so the procedure may be facilitated with endoscopic assistance.
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