69661 Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out

Name of the Procedure:

Stapedectomy or Stapedotomy with Reestablishment of Ossicular Continuity, with or without Use of Foreign Material; with Footplate Drill Out

Summary

A stapedectomy or stapedotomy is a surgical procedure aimed at improving hearing in patients with otosclerosis, a condition where abnormal bone growth in the middle ear impedes sound transmission. The operation involves removing part or all of the stapes bone and replacing it to restore proper sound conduction.

Purpose

The procedure addresses conductive hearing loss caused by otosclerosis. The goal is to enhance sound transmission through the middle ear, thereby improving hearing ability.

Indications

• Persistent conductive hearing loss.
• Hearing difficulties unresponsive to hearing aids.
• Diagnosis of otosclerosis confirmed by audiological and radiological tests.
• Suitable for patients in good general health who are able to undergo surgery.

Preparation

• Fasting for 6-8 hours prior to the procedure.
• Adjustments to medication as advised by the healthcare provider, especially blood thinners.
• Preoperative hearing tests and imaging studies.
• Discussion of medical history and allergies.

Procedure Description

1. The patient is administered general or local anesthesia with sedation.
2. An incision is made in the ear canal to expose the eardrum.
3. The eardrum is lifted to access the stapes bone.
4. Part or all of the stapes bone is removed using a laser or microdrill.
5. A prosthesis is inserted to reestablish ossicular continuity.
6. The footplate of the stapes is drilled out if necessary to ensure proper placement of the prosthesis.
7. The eardrum is repositioned and the incision is closed.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or specialized surgical center.

Personnel

• ENT Surgeon (Otolaryngologist)
• Surgical Nurse
• Anesthesiologist
• Audiologist (for postoperative hearing assessment)

Risks and Complications

• Infection
• Bleeding
• Changes in taste due to nerve damage
• Dizziness or balance issues
• Hearing loss
• Tinnitus

Benefits

• Improved hearing ability.
• Enhanced sound clarity and volume.
• Better quality of life with improved communication.
• Benefits are often realized within a few days to weeks post-surgery.

Recovery

• Patients typically go home the same day or after an overnight stay.
• Keep the ear dry and avoid strenuous activities.
• Pain management with prescribed medications.
• Follow-up appointments for removal of packing in the ear and hearing tests.
• Full recovery and return to normal activities usually take about 6 weeks.

Alternatives

• Hearing aids can be an alternative for those unable or unwilling to undergo surgery.
• Observation and regular audiological monitoring.
• Bone-anchored hearing systems or middle ear implants for certain cases.
• Pros of alternatives: Non-invasive, lower immediate risk.
• Cons: May not be as effective as surgery for certain cases.

Patient Experience

• Minimal pain and discomfort are expected during and after the procedure.
• Some initial dizziness or imbalance may occur, which usually subsides.
• Pain management through prescribed medications and rest.
• Ear might feel blocked or full until packing is removed.