Stapes Surgery
Stapedectomy: Surgical Treatment for Hearing Loss
A stapedectomy is a surgical procedure used to treat hearing loss which is conductive or mixed in nature and progressive, caused by disease called otosclerosis a condition that affects the stapes, a small U-shaped bone in the middle ear responsible for transmitting sound waves to the inner ear. When otosclerosis causes the stapes to fix and fuse with surrounding bone tissue, it loses its ability to vibrate like a piston, leading to hearing loss. During a stapedectomy, the damaged stapes is replaced with an artificial device called piston, restoring sound transmission and improving hearing.
Is a Stapedectomy a Major Surgery?
Although a stapedectomy is performed in an operating room under local or general anesthesia, it is generally not considered a major surgery but it’s a crucial surgery as it requires entry into the window (oval) of the inner ear.
and that requires a great deal of precision, delicate handling under microscopic magnification and experience of the operating surgeon
Pre-Surgery Evaluation
Before a stapedectomy, your healthcare provider will assess your hearing loss through:
- Medical History Review: Questions about hearing loss duration, tinnitus, vertigo, and family history of otosclerosis.
- Physical Examination: Checking for infections and evaluating the eardrum and ear canal.
- Audiometry Test: Assessing hearing ability through a range of tones (results shown in an audiogram).
- Tuning Fork Test: Comparing how sound travels through bone vs. air conduction.
- Tympanometry: Measuring eardrum movement for middle ear pressure and acoustic reflex using a handheld tympanometer (results displayed in a tympanogram).
- CT Scan: Providing detailed images of the ear’s bones and tissues to confirm the diagnosis and look for any anomalies or abnormalities in anatomy of middle ear structures.
What Happens During a Stapedectomy?
The procedure typically takes 90 minutes to two hours and involves:
- Administering Anesthesia– Either local or general anesthesia is used.
- Accessing the Middle Ear: micro-instruments are used to reach the eardrum after small incision in the ear canal which is not visible from outside.
- Lifting the Eardrum: This step exposes the stapes and middle ear bones.
- Removing and Replacing the Stapes: The fixation of stapes is confirmed and it’s then removed and replaced with an artificial device called a piston.
- most magical part of this surgery is that the hearing improvement happens right on the table after the procedure is complete and is assessed and confirmed by the operating surgeon and patient.
- Closing the Incision: The eardrum is repositioned, and bandages or special materials are applied to support healing.
Recovery and Post-Surgery Care
Healing after a stapedectomy usually takes about six weeks to three months. Here what to expect during recovery:
- Mild Pain or Discomfort for few days: Over-the-counter pain medications can help.
- Ear Discharge: Some blood stained discharge is normal which is actually the dressing material liquifying. cotton balls can be used to absorb it
- Antibiotic Ear Drops: Your doctor may prescribe ear drops to prevent infection.
- Keeping the Ear Dry: special attention to be paid especially while bathing Vaseline-coated cotton balls in the ear while showering may help and should be removed immediately after bathing, nowadays washproof disposable ear dressings are also available
- change in taste can be experienced for few days or few weeks to few months
- different sounds like ocean waves, crackling sounds etc can be experienced for few days to a week or two
- feeling of giddiness may be experienced by some, which subsides normally in few days to a week or two
- Avoiding Airplane Travel: Flying is discouraged for 4-6 weeks to prevent pressure-related complications.
- No Earbuds or In-Ear Devices: Avoid earbuds or hearing aids/ earphone devices until your ear has fully healed.
- so regular follow up as adviced should be followed for first 3 weeks , rest of the healing process is smooth and does not bother the patient much.
A stapedectomy is highly effective in treating otosclerosis-related hearing loss, helping restore sound transmission and improve quality of life. Always follow your healthcare provider’s instructions to ensure a smooth recovery!
