Stapedectomy

Overview

A stapedectomy is a surgical procedure aimed at restoring hearing by addressing damage in the middle ear caused by otosclerosis. This condition affects the stapes, a tiny, U-shaped bone that transmits sound vibrations to the inner ear. In the procedure, the damaged stapes is replaced with an artificial implant.

Reasons for undergoing the procedure

You might require a stapedectomy if your hearing loss is due to otosclerosis. This condition occurs when the stapes bone becomes fused with the surrounding bone tissue, losing the flexibility needed to transmit sound waves from the middle ear to the inner ear.

If you have otosclerosis, you might gradually notice difficulty hearing people whisper or have trouble detecting low-pitched sounds. Interestingly, you may find it easier to hear in noisy environments. Some individuals with otosclerosis may begin to speak more softly, thinking their voice is louder than it is. Other potential symptoms of otosclerosis include:

• Dizziness
• Ringing in the ears, or tinnitus
• Vertigo
• Issues in balancing

Risks

As with any surgical procedure, a stapedectomy carries the risk of complications. While it successfully improves hearing for about 80% to 90% of individuals with otosclerosis, it may not always be effective. In rare cases, your hearing could even worsen after the surgery. Potential issues include:

• Vertigo, which may occur immediately after the procedure and persist for a few days.
• Altered taste on one side of the tongue, typically resolving within a few months.
• Development of tinnitus (ear ringing).

If your hearing does not improve or worsens after surgery, additional procedures might be recommended, or your doctor may suggest using hearing aids. The most common signs of stapedectomy failure are persistent hearing loss or new hearing loss after the operation.

Before the procedure

Your doctor assesses your hearing loss prior to a stapedectomy. Your doctor may take the following actions:

• Find out about your health history. They might inquire about the duration of your hearing difficulties, the presence of vertigo or tinnitus, and any family history of otosclerosis.
• Conduct a physical assessment. Your doctor might examine you for recent or ongoing ear infections. They might check your eardrum (tympanic membrane) and ear canals.
  Conduct an audiometry. This test evaluates your range of tonality perception. Your audiogram shows the results of your exam.
• Assess your hearing loss by measuring the difference between the sound levels you hear through your ear and your bone with a tuning fork. To achieve this, they place the tuning fork on your mastoid bone, which is located behind your ear, then tap it on your ear.
• Examine your eardrum with a portable instrument known as a tympanometer. The name of this test is tympanometry. The findings of your test are shown on a tympanogram.
• Run a Computerized Tomography (CT) scan. Your doctor can examine the bones and tissues in your ear with this imaging examination.

During the procedure

Stapedectomies can take anywhere from 90 minutes to two hours to perform as outpatient procedures.

The following actions could be taken by your healthcare practitioner if you are having a stapedectomy:

• Give you anesthesia to make the procedure painless for you. Anesthesia might be applied locally or generally during a stapedectomy.
• To access your eardrum, use a laser or tiny tools. In order to access your eardrum, doctors may choose to create a little incision in front of or behind your ear.
• Raise your middle ear bones by lifting your eardrum.
• Take out your stape and put in an artificial one.
• Reinstall your eardrum to complete the procedure. Your doctor applies bandages or other material on your eardrum to hold it in place while your ear heals.

After the procedure

You’ll be allowed to go home once you’ve recovered from anesthesia. You’ll need to rest for the first few days after your procedure. The average person’s ears heal in six weeks or less. After your stapedectomy, you should anticipate the following additional things:

• There can be a bleeding oozing from your ear. If so, use cotton balls to gently absorb the fluid from your ear.
• Antibiotic drops for your ears may be prescribed by your doctor.
• You must ensure that your ear stays dry. Apply some Vaseline® on a cotton ball and insert it into your ear when you take a shower. After showering, gently pat the area around your outer ears dry.
• Airplane travel should be avoided until your ear heals. It could require four to six weeks. Flying puts pressure on your ear, and that pressure may dislodge your gadget.
• Don’t use earbuds until your ear heals.

Outcome

After a stapedectomy, most patients can return to their usual activities within about a week. However, those who engage in heavy lifting or other physically demanding tasks may need additional time off.