Stapedectomy is a surgery performed to remove the innermost bone, the stapes, one of the three bones of the middle ear and replace it with a prosthetic one. The surgery is done to alleviate the gradual development of hear loss caused by otosclerosis, a condition where the bone gets hardened at the base of stapes. The hardening of the bone prevents the stapes to move normally in a free position which results in hearing loss termed as conductive hearing loss. During the surgery the stapes is replaced with a prosthetic part. The surgery helps to recover from the hear loss and sound can be again transmitted to the inner ear from the ear drum.
- Hear loss due to growth of stapes.
- Presence of an air-bone gap of about 15 dB across 3 frequencies which will be confirmed with tuning-fork testing.
- The ear with poor hearing capacity based on the diagnosis tests should be qualified for surgery.
- In some patients where bilateral surgery is required it should be done after 6 months.
- Hearing test to determine conducive hear loss
- Tuning fork test
- CT scan
- Tympanogram test
- Hearing sensitivity audiogram
- Smoking should be avoided before 6-8 weeks of the procedure and also some weeks after the procedure.
- Some medicines such as aspirin should be avoided before the procedure as it may increase the risk of bleeding before and after the procedure.
- Certain medications which can be regularly consumed by the patient such as vitamin supplements and herbal medicines should be avoided before the surgery.
- Other regular medicines should be avoided a day before the procedure.
- Small infections such as common cold should be informed to the medical staff.
- Eating and drinking water should be avoided 6-12 hrs before the surgery.
- Specific tests should be taken before the surgery according to the recommendation of the surgeon.
- The surgery will be done usually in a hospital
- The patient may be given either local or general anaesthesia to relax and sedate the muscles and to prevent feeling pain during the surgery.
- The surgeon will enter near the ear drum and it will be lifted away from the middle ear.
- The surgeon will remove the part of stapes using a small drill or laser and will place an artificial stapes in the ear.
- The new stapes will be connected with the other two bones of the inner ear. The ear drum will be placed back in the correct position and ear pack will be placed in to ear canal.
- The surgery takes usually 1.5 to 2 hours.
- The patient may go home on the same day of the surgery.
- The medical staff will inform the patient when they can go back to normal activities.
- The patient may not feel better hearing immediately after the surgery because of the packaging inserted in to the ear after the surgery.
- A week after the surgery patient has to return to the doctor for check up.
- The hearing may not be improved until a month post surgery because of the bruising and swelling inside the ear.
- After the surgery the patient may experience ringing, dizziness or buzzing in the ear, change in taste after the surgery.
- Rarely some patients may feel temporary weakness on the part of the face where surgery was done
- You will have a hearing test 1 to 2 months after the surgery to see how well you are hearing.
- Some patients may feel sick due to the anaesthesia.
- Infection or bleeding at the site of surgery.
- During the procedure the eardrum may be perforated and may require another surgery to correct it.
- The hearing may not be better immediately after the surgery as sometimes the artificially placed stapes may slip from its position and may require another surgery to correct.
- In very rare cases hearing will be impaired so bad and hearing aids may also not be helpful.
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