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Stapedectomy Procedure Benefits Risks Care at Medicover Hospitals Frequently Asked Questions

Stapedectomy

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.


Procedure

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.

Benefits

Stapedectomy is an effective surgical procedure for treating otosclerosis that leads to improvement in a patient's quality of life. Some of the benefits of stapedectomy are improved hearing, minimal surgical trauma and less pain.

Risks

  • Nausea and dizziness : This is common and expected after surgery and is usually mild and short lived. Many medications are given to prevent these and only a few patients feel dizzy beyond the day of surgery. Some patients feel sensitive to motion for a few days. Driving is restricted until this resolves, usually no more than a few days.
  • Temporary change in taste: A nerve of taste runs under the eardrum and has to be moved out of the way during surgery. This can leave a loss of taste or taste change on the side of the tongue which is usually temporary.
  • No improvement in the hearing or lack of significant improvement can occur in 1-2% of cases.
  • High frequency hearing loss can occur in 5-10% but the improvement in other frequencies usually makes up for this.
  • Tinnitus usually improves with hearing improvement after surgery, but in rare cases it can worsen.
  • A perforated eardrum or damage to the other ear bones are rare.
  • Facial nerve paralysis is extremely rare.

Stapedectomy Care at Medicover Hospitals

The department of ENT at Medicover Hospital treats a wide range of ear, nose, and throat conditions in both adults and children. Our ENT department is comprised of qualified and trained ENT surgeons, head and neck surgeons with vast experience in all aspects of otolaryngology. The department has a track record of successfully completing some of the most complex procedures.


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Frequently Asked Questions

1. What is a stapedectomy?

A stapedectomy is a surgical procedure performed to treat hearing loss caused by a condition known as otosclerosis. In this procedure, the surgeon removes a portion of the stapes bone in the middle ear and replaces it with a prosthetic device, known as a stapes prosthesis.

2. How long does a stapedectomy take?

The procedure typically takes around 1-2 hours to complete, and is usually performed under local anesthesia or in general anesthesia.

3. What is the success rate of a stapedectomy?

The success rate of stapedectomy varies, but it is generally considered to be an effective and safe procedure. Success rates can range from >90% for improving hearing to around 95% for maintaining or stabilizing existing hearing.

4. What is the recovery time after a stapedectomy?

The recovery time after a stapedectomy can vary, but most people can return to their normal activities within 2-4 weeks after the surgery. It is important to avoid heavy lifting, straining, or blowing the nose during this time, as these activities can increase pressure in the ear and affect the healing process.

5. Are there any risks associated with stapedectomy?

Like all surgeries, there are some risks associated with stapedectomy, including infection, giddiness, hearing loss, tinnitus (ringing in the ear), and facial nerve paralysis. However, these risks are relatively rare and the benefits of the surgery typically outweigh the risks.

6. Can stapedectomy be performed on both ears at the same time?

The surgery is done one ear at a time. If surgery on the second ear is required, it can be done usually 1 year or more after the first.

7. Is the prosthesis designed to be permanent?

The prosthesis is intended to be permanent. On rare occasions, there may be a problem with the healing pattern, and the prosthesis may need to be revised.

8. What is a revision stapedectomy?

When the first surgery is ineffective, a revision stapedectomy is recommended. This is essentially a stapedectomy in an ear that has already had one stapedectomy procedure.

9. Who is a candidate for a stapedectomy?

A stapedectomy is an option for patients who have otosclerosis and significant hearing loss. To determine the appropriateness of a stapedectomy, each patient undergoes audiometric (hearing) tests, an ear examination, and a consultation with the ear surgeon.

Citations

https://uihc.org/services/stapedectomy
https://www.mountsinai.org/locations/center-hearing-balance/conditions/otosclerosis
https://www.marshfieldclinic.org/specialties/ent/stapedectomy#