Otosclerosis is a focal lesion of unknown origin in the bony vagus, with a high incidence in women aged 20-40 years. It can be classified as histological otosclerosis, stapedial otosclerosis and cochlear otosclerosis according to the location and clinical manifestations of the lesion. The main symptoms are: progressive hearing loss, tinnitus or vertigo. Otosclerosis surgery is a difficult otologic procedure for patients with stapedial otosclerosis who have progressive hearing loss, tinnitus, or vertigo due to a lesion affecting the circumferential ligament and limiting or fixing the stapes. Otosclerosis surgery is the most exciting and rewarding microsurgery for the otolaryngologist, and complete closure of the air-bone conduction gap at all frequencies after surgery is the ultimate goal of the surgeon. The most commonly used surgical method is the stapes pedicle drilling piston, which has the advantages of good results, stable hearing outcomes over time, and mild postoperative reactions. There are three important factors for a perfect surgical outcome: First, the precise and delicate operation during the procedure. The second is the measurement, i.e. the distance from the long foot of the anvil to the floor of the stapes, from which the depth of entry of the pistonlet into the vestibule can be determined. If the piston is implanted too deep, it may stimulate the ectolymph and cause vertigo, while if it is implanted too shallow, the hearing improvement effect will be poor, and the general depth of entry into the vestibule is between 0.25-0.5mm. Third, the selection of materials, the selection of suitable pistons for patients is also a guarantee of surgical results, the authors believe that the selection of 0.6mm diameter pistons is most appropriate, because its vibration area is large enough, and stability is also better. In addition, the piston with metal wire hook (such as gold, platinum, pure titanium wire, etc.) can ensure that the piston small column and the long foot of the anvil bone are closely connected. Some studies have shown that the piston small column and the long foot of the anvil bone are not closely connected, and the postoperative hearing often has a 5-10 dB air-bone conduction gap. In addition, there is a 5-15dB difference in air-bone conduction between 0,6mm and 0,3-0,4mm postoperative hearing improvement, but there is no difference compared with 0,6mm or more diameter post. Preoperative preparation】 1. Spiral CT was performed to identify the site of sclerosis. 2.Shave the hair and prepare the skin five fingers wide behind the ear. 3.Take phenobarbital 0.06g 2 hours before surgery or inject diazepam (Valium) 10mg 1 hour before surgery. [Position] Supine lateral head position. Anesthesia】 Generally use local anesthesia or intensive anesthesia. Postoperative treatment】 1. Use penicillin and other antibiotics to prevent infection. 2, with nausea, dizziness phenomenon available diazepam oral, a few days to heal. 3, 1 month after surgery avoid heavy physical labor, avoid the noise environment.