The management of otosclerosis is viewed by many as the sine qua non of an otologic practice. From the elegant otopathologic descriptions by Ádám Politzer1 in the 19th century to surgical breakthroughs by Julius Lempert2 and John Shea Jr3 in the mid-20th century, otosclerosis and its surgical management have inspired generations of students, researchers, and surgeons alike. The allure of stapedectomy may be, in part, the elegant tightrope walk to fix hearing loss along with the anticipation of a surgeon report card that arrives in the form of an audiogram. Although the surgical treatment of otosclerosis has not drastically changed since its description by Shea,3 otosclerosis and its management remain fertile ground for research, debate, and refinement. Indeed, novel 21st-century diagnoses—such as superior canal dehiscence syndrome; technological refinements, including otoendoscopy; and even inner-ear drug delivery4—appear to be viewed in connection to otosclerosis.