Procedure

Stapedectomy- Ear Nose And Throat (ENT)

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Stapedectomy is a type of surgery in which the deepest bone (stapes) of the three bones (the stapes, the incus, and the malleus) of the middle ear is removed, and supplanted with a prosthesis. This is performed to enhance the conduct of sound to the internal ear. Stapedectomy treats progressive hearing loss that is caused by otosclerosis, a medical condition in which spongy bone solidifies around the base of the stapes.

Why is stapedectomy required?

Doctors do this surgical procedure when otosclerosis is the cause of your hearing loss. The doctor will first treat the more affected ear if the condition affects the two ears.

Not all people with otosclerosis require stapedectomy. If the loss of hearing isn't serious enough to require a surgical procedure, they may not need this procedure. In these cases, people may use hearing aids for hearing.

Stapedectomy is performed because of the following reasons:

  • Conductive hearing loss that is due to problems in stapes fixation
  • Good health, able to tolerate anesthesia, especially general anesthesia
  • Good cochlear reserve, as seen with good speech discrimination

Which doctor to consult?

An ENT surgeon performs stapedectomy to place an artificial part that replaces the stapes.

What to expect during stapedectomy?

The surgeon will do stapedectomy at a hospital or surgery center.

You will receive a general or local anesthetic that will put you to sleep and will prevent you from feeling any pain during the surgery. Frequently, an outside incision isn't required since the surgeon can access the ear channel to get to the middle ear.

The surgeon will then use an operating microscope to create an incision in your ear canal. He or she will lift your eardrum cautiously.                                                                                                                                                       

They will then remove the part of the stapes that are situated close to the middle ear bones and will use either a laser or a drill to make a little opening in the area of the stapes near your inner ear.                                                                                                                                                                                                             

They will then put one end of a small plastic or metal cylinder or piston in the opening, connecting the opposite end nearest to your middle ear bone. The cylinder works like a moveable connection between your inner ear and the middle ear bones. Sound waves will cause vibration in your eardrum which will then move the cylinder and your middle ear bones.

The doctor will then restore your eardrum to the usual position and set it up with a pressing material for the entire recovery period.

If your surgeon finds that the stapes are not otosclerotic, or that it moves after they open your ear canal, they will correct your hearing with another type of prosthesis. The whole procedure takes around 1.5 to 2.5 hours to finish.

Post-operative care

You'll start your stapedectomy recovery in the hospital for a few hours. You can go home if you do not feel any nausea or dizziness after the procedure.

You may have headache or ear pain and be somewhat dizzy for a couple of days following your procedure. You may feel like your ear is "stuffy" or blocked. As the eardrum starts recovering, and your doctor removes the dressing or cotton they have stuffed in your ear canal, your symptoms will show signs of improvement. They may remove the packing 14 days after the surgery. You may see some bloody fluid depleting from your ear a day or two after the doctor removes the pack.

It might take some weeks before you can have any changes in your hearing or it might improve faster. It will continue to improve in the following months after the procedure. During the recovery time, avoid getting water into your ears.

You will experience sensitivity to noise first, so stay away from loud noise. Also, you should avoid swimming, riding an airplane, playing contact sports or scuba diving right after the procedure.

Complications

You may have some side effects and risks, so talk to your doctor about them. Some potential side effects of the procedure may include:

Dizziness and nausea

These manifestations are usual after any surgery. They will only last for a few days. Your doctor will give you medicines for these side effects. You may likewise encounter some dizziness after your procedure.

Temporary taste changes

You may have temporary taste changes on one side your tongue or a loss of taste, but this is temporary.

Tinnitus or ringing of the ears

This may improve after the procedure, along with hearing improvement.

Anesthesia risks

Discuss about these risks with your doctor.

Bleeding or infection

These manifestations could happen. Discuss this with your doctor

Keep in mind that each treatment or surgery has its own risks. Discuss with your doctor early to perceive how they may apply to you. Your doctor will answer any inquiries you may have and may address your concerns.

References

  • Leider C. What is a Stapedectomy Surgery? (Indications, Procedure, Side Effects, and Recovery). Houstonent.com. https://www.houstonent.com/blog/what-is-a-stapedectomy-surgery-indications-procedure-side-effects-and-recovery. Published 2019. Accessed January 13, 2019.
  • Stapedectomy. En.wikipedia.org. https://en.wikipedia.org/wiki/Stapedectomy. Published 2019. Accessed January 13, 2019.
  • Stapedectomy Surgery - Darius Kohan, MD - Otologist NYC. Otologist NYC. https://dariuskohanmd.com/stapedectomy-surgery-nyc/. Published 2019. Accessed January 13, 2019.
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