Miss Chen is an excellent young nurse in a hospital, skilled, conscientious and responsible work, and has been awarded the service star many times. But in the past six months she has been repeatedly complained by patients and their families, that she ignored the call of the patient, and often answer the question. Miss Chen felt very aggrieved, it turned out to be a hearing problem. Miss Chen had tinnitus in both ears a year ago after pregnancy, but did not pay attention to it because of her busy schedule. After the birth of a baby tinnitus more serious, Miss Chen thought it was too tired to take care of the baby, and did not care much. But in the past six months, her tinnitus has gradually worsened and her hearing has decreased significantly, and now she has developed to the point that she often needs to repeat herself several times before she can hear people. After a detailed examination, she was diagnosed with moderate to severe conductive deafness and otosclerosis, which required surgery. Ms. Chen underwent CO2 laser-assisted small window technique artificial stapes installation. Due to the severe degree of tinnitus and hearing loss in the right ear, the surgery was first performed on Ms. Chen’s right ear, and the results were very satisfactory. On the operating table, Ms. Chen felt that the hearing in her right ear had improved significantly, and the tinnitus on that side was also significantly reduced. Ms. Chen was so happy that she made an appointment to have another surgery on her left ear in six months. Most patients hear well in a noisy environment. In otosclerosis, the normal bone of the stapes is resorbed and replaced by new spongy bone rich in blood vessels, leading to fixation of the stapes and loss of normal sound transmission and amplification functions, which will affect the sound perception function when the lesion further develops and invades the cochlea. The patient often presents with progressive conductive deafness and tinnitus, which may develop in one ear in the early stages and in both ears in the later stages, with tinnitus appearing earlier than deafness. If left untreated, the lesion may develop further and mixed deafness may occur, with both conductive and sensorineural deafness. Hearing loss in the vast majority of patients with otosclerosis begins between the ages of 10 and 30. Due to the insidious nature of early symptoms, some patients have difficulty describing exactly when deafness begins, and in some female patients, deafness worsens in specific states such as pregnancy and childbirth, as was the case with Ms. Chen. An important feature of the disease is that patients have difficulty hearing in quiet environments, while their hearing improves in noisy environments, a phenomenon known as Wechsler mishearing, which occurs in 20% to 80% of cases. Another interesting phenomenon is that some patients with otosclerosis do not speak as loudly as patients with deafness in the usual sense, but instead may have a characteristic “whispering voice” style of speech. The reason for this is that the patient is conductively deaf and the sound of his or her own speech is more easily transmitted to his or her inner ear, resulting in enhanced self-hearing. Clinically, patients with conductive deafness or mixed deafness without a history of otitis media and with an intact tympanic membrane should be alerted to the possibility of otosclerosis, and timely audiological examination can help to make a clear diagnosis and provide early intervention to restore or improve hearing, so that irreversible sensorineural hearing loss does not occur at a later stage of the disease and is difficult to manage. Because the cause of otosclerosis is unknown, there is no effective treatment for the cause. Clinically, the basic pathological change of otosclerosis, stapes fixation, is often targeted, and the active stapes are surgically restored or reconstructed to obtain a hearing chain with sound transmission and amplification functions, thus restoring and improving hearing impairment. The main surgical methods include stirrup shaking and artificial stirrup installation. The Sixth People’s Hospital of Shanghai Jiaotong University has been performing these surgeries since the 1970s, and has performed artificial stapes surgery for more than 1,000 patients with otosclerosis, with a success rate of more than 90% in one operation. Due to the inexact long-term efficacy of traditional surgical methods, or the intraoperative and postoperative complications of vertigo, sensorineural deafness and facial nerve palsy, a significant number of patients have doubts about surgical treatment. The small window technique is currently the mainstream technique for otosclerosis surgery in Europe and the United States. In contrast to the traditional practice of partial or complete removal of the stapes, a small window is opened in the center of the stapes floor and an artificial stapes is installed to reconstruct the auditory chain with sound transmission function. This technique greatly improves surgical safety and reduces postoperative reactions because it causes less disturbance to the inner ear vagus. In recent years, due to the application of laser technology in ear surgery, the key steps of stapes surgery, such as the opening of the stirrup base plate, which used to be technically difficult and risky, have been replaced by laser technology, which minimizes the trauma to the inner ear and the damage to the facial nerve, and greatly reduces the risk of sensorineural deafness, vertigo and facial palsy. However, since this technique is based on partial or complete stapedectomy and requires the installation of an artificial stapes on the overhanging auditory tuberosity, the actual operation is still risky. The Department of Otolaryngology of the Sixth People’s Hospital of Shanghai Jiaotong University has improved this technique by using the precise and efficient thermal effect of the laser to first open a small window in the center of the stapes floor and install the artificial stapes with the auditory chain intact, followed by resection of the fixed stapes, which further improves the success rate and safety of the operation, reduces the incidence of intraoperative and postoperative complications, and significantly reduces postoperative reactions. Statistics at home and abroad show that CO2 laser-assisted stapes fitting with small window technology is a reliable technique for otosclerosis treatment because of its remarkable efficacy, mild postoperative reactions and stable long-term efficacy.