Stapes, also known as the stirrup bone, is one of three bones essential for hearing. Sound causes the stapes bone to vibrate. The vibrations pass into the fluid of the inner ear and that allows you to hear. Hearing will be decreased or lost if the stapes cannot vibrate. If you have otosclerosis, the stapes can't move, causing hearing loss. A surgery called stapedectomy can help.
People with otosclerosis who have lost their hearing may be candidates for stapedectomy. Difficulty hearing during conversations, while chewing, or in noisy environments are early signs of otosclerosis. Otosclerosis is diagnosed with physical examination by an otolaryngologist (a doctor who treats the ears, nose, and throat), hearing test and a CT (computed tomography) scan to examine the ear bones.
Before the Procedure
Before undergoing the stapedectomy procedure, the ENT specialist will:
- First, the medical history of the patient is reviewed and evaluated for the signs and symptoms.
- Tests, such as blood tests are performed to check overall health and to test hearing before the procedure.
- The procedural approach is explained in detail and its potential risks.
- The doctor provides precautionary measures that a patient needs to take before the surgery.
- Doctor may prescribe some medicines that the patient needs to take on the day of the surgery. The patient should take these medicines with a sip of water.
- The patient is advised to stop certain medications, such as blood thinner that may increase the risk of complications during or after surgery.
- Doctor may advise not to eat or drink anything from midnight before the day of the procedure.
- The patient should also inform the doctor about any medication and supplements he/she is taking.
During the Procedure
- The doctor uses a small microscope to examine the small bones of the inner ear during stapedectomy. Entering through the natural opening in your ear, the surgeon will lift the eardrum and separate the stapes and incus(another bone in the ear). After this, the surgeon will remove the stapes bone using a micro drill or laser.
- Then the surgeons will insert a prosthesis made of Teflon or titanium in place of the stapes. The prosthesis transmits sound vibrations to your inner ear, thereby restoring hearing. To seal the surgical opening, fatty tissue will be taken out from a small incision behind the ear. At the end of the procedure, the eardrum is replaced.
- Hearing usually returns about four week after surgery and improves thereafter.
After the Procedure
- Patients usually leave the hospital the same day and are encouraged to rest at home and avoid strenuous work for two week after surgery.
- After surgery, the patient stays in bed for 2 hours to prevent nausea and vomiting and is then discharged home. Activity is fairly restricted for the first week, and then a gradual return to activity can occur, but heavy exercise, straining, blowing the nose, flying or lifting anything more than 4.5 kg needs to be avoided for 4-6 weeks. The packing is removed in the office one week after surgery and the hearing gradually returns over the next month. Water needs to be kept out of the ear for 2-3 weeks.
- The hearing usually begins to improve one week after the first postoperative visit. The gain in hearing is usually rapid and permanent, and the prosthesis rarely fails.
- You should refrain from blowing your nose for at least four weeks. Any accumulation in the nose may be drawn back and expectorated through the mouth.