Stapedectomy Surgery: Diagnosis, Procedure and Recovery

What is otosclerosis?

In order to understand stapedectomy, understanding otosclerosis is also important. Otosclerosis is an inherited disorder caused by abnormal bone growth in the middle ear. In this condition, the stape bones become fixated and immobile and prevents the sound from amplifying. This leads to hearing loss, ringing in the ears, dizziness, balance problems, etc. The treatment generally comprises hearing aids and surgery.

Who needs stapedectomy surgery?

The surgeons suggest Stapedectomy surgery when the cause of hearing loss is otosclerosis. The ideal candidates for Stapedectomy surgery are:

• Patients who have suffered conductive hearing loss caused by stapes fixation.
• Patients who have shown impressive cochlear reserve through good speech discrimination presence.
• Those who have good overall health, and no allergies to anesthesia. The surgeon might conduct tests to assess your health before the surgery.

However, not all patients with otosclerosis require surgery. In some cases, the hearing loss isn’t too serious and patients try to manage it with a hearing aid instead of surgery.

What Is The Procedure Of Stapedectomy?

Diagnosis

Before suggesting stapedectomy, an ENT specialist performs a thorough diagnosis to evaluate your overall health. The assessment may consist of:

• Understanding medical history: The doctor asks questions related to your medical history and the symptoms you're experiencing such as trouble hearing, tinnitus, or vertigo. He/she may also ask questions related to the history of otosclerosis in your family.
• Physical Examination: In the physical examination, the ENT specialists examine your ear to look for acute or chronic ear infections. They also assess your ear canal and eardrum.
• Audiometry: In this test, the surgeon checks your ability to hear different tones. The result is displayed in an audiogram.
• Tuning Fork Test: In this test, the doctors use a tuning fork to compare how well you hear different ed sounds through your bone and your ear. They do it by tapping the tuning fork and putting it on the mastoid bone behind the ear and then on the ear.
• Tympanometry: In this test, the doctors use a tympanometer to check your eardrum. The result shows on the tympanogram.
• CT Scan: The doctors suggest this imaging test to examine the bones and tissues in your ear.

How is stapedectomy surgery performed?

The stapedectomy surgery generally takes 1.5 hours to 2.5 hours. It is usually performed in a hospital or a surgical center. The surgeons perform this surgery under general or local anesthetic. A general anesthetic relaxes your muscles, puts you to sleep, and doesn’t let you feel any pain during the surgery. A local anesthetic numbs the area of your body to be operated on, in this case, the ear. The surgery is carried out in the following steps:

1. The surgeon starts by making an incision in the ear canal using a microscopic tool. They lift the eardrum carefully to do that.
2. They then extract the part of the stapes located near the other middle-ear bones. Then, they use a laser or drill to create a small hole in the area of the stapes close to the inner ear.
3. Next, they place an end of a tiny plastic or metal cylinder in the hole and attach it to the other end closest to the middle-ear bone. The piston works like a moveable link between the inner ear and the remaining middle-ear bones. Sound waves cause vibration in the eardrum which then moves the piston and the middle ear bones.
4. Finally, the surgeon returns the eardrum to its normal position and sets it in place with packing material for stapedectomy recovery.

If the surgeon notices that the stapes is not otosclerotic i.e., it moves after they open your ear canal, they can still correct the hearing with a different type of prosthesis.

How to prepare for stapedectomy surgery?

Prepare for your stapedectomy to prevent any inconvenience at the time of the surgery. Here's how you can prepare for the surgery:

• Talk to your doctor about the medicines that you take regularly. Your doctor might suggest you stop taking aspirin, warfarin, and a couple of other medicines for a few days before the surgery. This is done to reduce the risk of excessive bleeding during and after the surgery.
• Get all the diagnostic tests done and share your reports with the doctor. These tests will help the doctor rule out underlying health conditions that might cause complications during the surgery.
• Follow your doctor's dietary instructions before the surgery. He/she might ask you to restrict your consumption of food and fluids before the surgery.

What to expect after Stapedectomy surgery?

Here's what you can expect after your stapedectomy surgery:

1. You will be discharged from the hospital after the effect of anesthesia wears off.
2. The doctor will ask you to take complete rest for a couple of days after the surgery. In most cases, the operated ear takes about six weeks to heal.
3. You may notice some bloody discharge from your ear after the surgery. Use dry cotton balls in your ear to absorb the discharge. If you experience abnormal bleeding, immediately get in touch with your doctor.
4. Your healthcare provider may prescribe antibiotic drops for your ear. Make sure you take the prescribed medicines on time.
5. Make sure that the operated ear is dry at all times. Use a cotton ball while showering. Also, gently pat dry the area outside your ear after the shower.
6. You should avoid flying in airplanes until your ear heals. That may take four to six weeks. Flying puts pressure on your ear, and that pressure may dislodge your device.
7. Do not use any foreign objects, such as earbuds till the ear is completely healed.

What are the complications associated with stapedectomy surgery?

The risk of developing complications associated with Stapedectomy is quite low. However, anyone undergoing this surgery must be aware of the potential risks and complications associated with it. So, on that note, listed below are some common risks and complications associated with stapedectomy:

• Dizziness and nausea: This is one of the most commonly reported complications after surgery. Generally, this complication is short-lived and does not require a doctor's intervention. You might also experience mild dizziness and sensitivity to motion. Your doctor will prescribe medicines to help you manage these symptoms.
• Taste change: There's a taste nerve that runs under your eardrum. Before the surgery, the surgeon will be required to move this nerve out of the way. This could lead to a temporary taste change on the side of your tongue or loss of taste.
• High-frequency loss of hearing: Some patients report experiencing high-frequency hearing loss. However, you'll have an improvement in the other frequencies.
• No improvement in hearing after the surgery.
• Damage to another ear bone or a perforated eardrum: This complication is quite rare.
• Tinnitus or ringing in the ears. This generally improves after surgery with improvement in hearing. However, it can worsen in rare cases.
• Absolute loss of hearing: This complication is very rare.
• Facial nerve paralysis: It occurs in some cases, however, the possibility is very low.
• Recurring loss of hearing: In some cases, the hearing loss becomes recurrent. In such cases, they might have to undergo another surgery.
• Allergic reaction to anesthesia: Some patients are allergic to anaesthesia and may develop a reaction to it. The surgeon generally rules out the possibility of an allergic reaction to anesthesia before performing the surgery.
• Bleeding or infection: These complications can also occur in some cases.
• Tear or hole in your eardrum. In this case, the patient requires another surgery.

Book your appointment for cost-effective and safe Stapedectomy surgery at Pristyn Care by filling out the form or getting in touch with your care coordinator on the below-mentioned contact number