Hello, I’m Dr. Shree Rao. If you’re reading this, you may be considering a stapedectomy. This is recommended by doctors if the individual is struggling with hearing loss caused by a disorder called ‘otosclerosis’. Stapedectomy or stapes surgery is performed to remove the fixed, fused, or hardened stapes bone in the middle ear, which helps prevent progressive hearing impairment.
Is Stapedectomy a major surgery?
One of the most common questions I hear from patients is, “Is stapedectomy a major surgery?” My answer is always, “No. However, it is a highly delicate and specialized ear surgery.”
Stapedectomy is often classified as an outpatient procedure and can sometimes be done under local anaesthesia without the requirement of a ventilator or advanced breathing support. The surgery typically lasts for a period of 45 to 90 minutes, with no external cuts made.
Can you explain the stapedectomy procedure?
This minimally to moderately invasive microsurgery is believed to be a comfortable and well-tolerated procedure. Patients typically do not experience pain during the procedure. The patient may sense gentle sounds, pressure, or vibration in the ear, which is normal and momentary. Some patients notice clicking or buzzing noises during the microsurgery. The following steps are generally carried out by the doctor:
Step 1: The patient is administered either local or general anaesthesia.
Step 2: The doctor works through the ear canal using a surgical microscope or laser to view the tiny bones of the middle ear.
Step 3: The fixed stapes bone is partially or fully removed, as required.
Step 4: A tiny artificial implant, known as a prosthesis (often made of Teflon, titanium, or plastic), is placed to bridge the space and restore sound conduction.
Step 5: The eardrum is positioned back into position, and the ear is gently packed with gauze to enable healing.
What are the potential risks and complications involved?
Stapedectomy is safe when performed by an experienced ENT specialist. Like most surgeries, it carries potential risks such as:
- Tinnitus: Ringing or buzzing in the ear may develop or increase.
- Dizziness and Vertigo: Many people experience dizziness or a sense of imbalance for a few days after this procedure.
- Change in Taste: A temporary or rarely permanent change in taste on one side of the tongue, as the nerve responsible for taste exists close to the surgical site.
- Facial Nerve Weakness: An extremely rare complication due to the nerve’s closeness to the site.
- Hearing Loss: In less than 1% of cases, surgery may result in total deafness or worsened hearing.
How long is the recovery period after surgery?
Most patients can return home the same day or the day after surgery. However, complete recovery and the final hearing results may take several weeks.
Key Recovery Milestones:
First 7 to 14 days: Packing is taken out from the ear canal.
15 to 30 days: Noticeable hearing improvement can be observed, though the ear may feel ‘blocked’ in the beginning.
Up to 8 weeks: Hearing often continues to improve during this period post-surgery.
Precautions:
Avoid strenuous activity, heavy lifting, and bending for several weeks. Stay away from air travel for one to one and a half months, as pressure changes can displace the new prosthesis. Patients must keep their ears dry and avoid blowing their noses forcefully while the area heals.
What is the success rate of Stapedectomy?
The success rate for a stapedectomy is high, with about 85% to 95% of patients experiencing a significant improvement in their hearing. In many cases, the surgery can even remove the need for hearing aids entirely.
Final Thoughts
While stapedectomy may sound intimidating, it is not a major surgery in the conventional sense. It is a safe and effective procedure that can greatly improve hearing and quality of life when performed by an experienced ENT surgeon.
If you or a loved one has otosclerosis-related hearing loss, a comprehensive consultation can help decide if stapedectomy is the right alternative. Book an appointment right away and take the first step toward long-term hearing success.
https://www.nidcd.nih.gov/health/otosclerosis
https://my.clevelandclinic.org/health/treatments/22382-stapedectomy
