Stapes mobilization
CPT4 code
Name of the Procedure:
Stapes Mobilization
Also known as: Stapes Surgery, Ossicular Chain Mobilization.
Summary
Stapes mobilization is a surgical procedure aimed at improving hearing. It involves restoring the movement of the stapes bone, which is one of the tiny bones in the middle ear, to improve the transmission of sound to the inner ear.
Purpose
The procedure addresses hearing loss caused by otosclerosis, a condition where the stapes bone becomes fixed due to abnormal bone growth. The goal is to enhance sound conduction, thereby improving hearing ability.
Indications
- Conductive hearing loss that does not respond to hearing aids.
- Diagnosis of otosclerosis.
- Impaired mobility of the stapes bone confirmed by audiometric tests.
Preparation
- Patients may need to fast (no food or drink) for at least 8 hours before the procedure.
- Medications might need adjustment; instructions will be provided by the surgeon.
- Audiometric tests and imaging studies, such as CT scans, may be conducted prior to surgery.
Procedure Description
- Anesthesia: The procedure is usually performed under local or general anesthesia.
- Access: An incision is made in the ear canal to expose the eardrum.
- Eardrum Inspection: The eardrum is carefully lifted to access the middle ear.
- Stapes Mobilization: The surgeon uses micro-instruments to carefully move the stapes bone to restore its mobility.
- Closure: The eardrum is repositioned, and the ear canal incision is closed.
Tools used include microscopes, micro-instruments, and lasers for precision.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Stapes mobilization is performed in a hospital operating room or an outpatient surgical center.
Personnel
- Surgeon: An otolaryngologist (ENT specialist) performs the surgery.
- Nurses: Provide intraoperative assistance and post-operative care.
- Anesthesiologist: Administers and monitors anesthesia.
Risks and Complications
- Common risks: Temporary dizziness, nausea, mild discomfort.
- Rare risks: Persistent hearing loss, tinnitus, infection, taste changes, perforation of the eardrum, facial nerve injury.
Benefits
- Improved hearing, often noticeable shortly after recovery.
- Enhanced quality of life due to better communication abilities.
Recovery
- Post-procedure Care: Patients may need to stay in a recovery area for observation.
- Instructions: Avoid water in the ear, refrain from strenuous activities, follow-up appointments for check-ups and audiometric assessments.
- Recovery Time: Generally, a few days to a week, with full recovery and hearing improvement over several weeks.
Alternatives
- Hearing Aids: Non-surgical option for mild cases; less effective for severe otosclerosis.
- Other Surgeries: Stapedectomy or stapedotomy, which involve removing or replacing parts of the stapes bone.
- Pros and Cons: Alternatives may vary in effectiveness and invasiveness; patient's specific condition guides the choice.
Patient Experience
- During the procedure: Patients under general anesthesia will be asleep; those under local anesthesia may feel minimal discomfort.
- After the procedure: Some temporary dizziness and mild discomfort are common. Pain management includes prescribed medications to ease any discomfort.
Most patients are satisfied with the outcome and experience significant improvements in their hearing and overall quality of life.