Name of the Procedure:

Stapedectomy or Stapedotomy with Reestablishment of Ossicular Continuity, with or without use of foreign material.

Summary

This procedure involves removing part or all of the stapes bone in the middle ear and restoring the chain of bones that conduct sound, sometimes using prosthetic materials.

Purpose

The procedure addresses conductive hearing loss due to otosclerosis, a condition that causes abnormal bone growth around the stapes bone. The goal is to improve hearing by allowing sound to be transmitted more effectively to the inner ear.

Indications

• Hearing loss that interferes with daily activities
• Diagnosed otosclerosis
• Lack of improvement with hearing aids

Preparation

• Fasting typically required 6-8 hours before the procedure.
• Review of medical history and medications.
• A hearing test (audiogram) and imaging studies, such as CT scan.

Procedure Description

1. The patient is given general or local anesthesia.
2. A small incision is made in the ear canal or behind the ear.
3. The stapes bone is located and partially or completely removed.
4. A prosthetic device may be inserted to replace the stapes and reestablish the ossicular chain.
5. The incision is closed and the ear is packed with a special dressing.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital or surgical center, often on an outpatient basis.

Personnel

• ENT (Ear, Nose, and Throat) Surgeon
• Anesthesiologist
• Surgical Nurse
• Audiologist (for pre- and post-operative hearing tests)

Risks and Complications

• Hearing loss
• Dizziness or vertigo
• Infection
• Tinnitus (ringing in the ear)
• Taste changes
• Facial nerve injury (rare)

Benefits

• Improved hearing, often noticeable within a few weeks.
• Enhanced ability to engage in conversations and daily activities.

Recovery

• Patients typically go home the same day or after an overnight stay.
• Avoid heavy lifting, straining, and swimming for several weeks.
• Follow-up appointment within a week to assess healing and remove ear packing.
• Gradual return to normal activities within 1-2 weeks.

Alternatives

• Hearing aids: Non-invasive but may not be as effective.
• Bone-anchored hearing systems: An implantable solution, but involves a different surgical approach.
• Cochlear implants: Another surgical option, usually for more severe hearing loss.

Patient Experience

• The patient will be sedated or asleep during the procedure and should feel minimal discomfort.
• Post-procedure, there may be a feeling of fullness in the ear and mild discomfort.
• Pain is generally manageable with prescribed medications. Regular follow-up ensures proper recovery and hearing improvement.