69662 Revision of stapedectomy or stapedotomy

Name of the Procedure:

Revision of stapedectomy or stapedotomy

• Common Name(s): Revision ear surgery
• Medical Term: Revision of stapedectomy or stapedotomy

Summary

Revision of a stapedectomy or stapedotomy is a surgical procedure to correct or improve a previous surgery conducted on the stapes bone in the middle ear. This bone plays a crucial role in hearing by transmitting sound vibrations to the inner ear.

Purpose

• Medical Condition: This procedure addresses conditions like hearing loss and otosclerosis (abnormal bone growth in the ear).
• Goals/Outcomes: The primary goal is to restore or improve hearing and relieve any other problematic symptoms from the initial surgery.

Indications

• Persistent or worsened hearing loss post-initial surgery.
• Vertigo, dizziness, or balance issues.
• Tinnitus (ringing in the ear) not improved by the initial surgery.
• Displacement or malfunction of the prosthetic device inserted during the first surgery.

Preparation

• Patients might be asked to fast for at least 6-8 hours before the procedure.
• Medications, especially blood thinners, may need to be adjusted or paused.
• Pre-operative hearing tests and imaging studies like CT scans to plan the revision surgery.

Procedure Description

1. Anesthesia: General anesthesia is typically administered to ensure the patient is asleep and pain-free.
2. Ear Access: An incision is made, usually behind the ear or in the ear canal, to provide access to the middle ear.
3. Assessment and Correction: The surgeon examines the existing prosthesis and middle ear structures. If necessary, the prosthetic is repositioned, replaced, or modified.
4. Closure: The incision is sutured closed, and a sterile dressing is applied.

• Tools/Equipment: Microscope, various small surgical instruments, prosthetic devices.

Duration

The procedure typically lasts between 1 to 3 hours.

Setting

The surgery is performed in a hospital operating room or a specialized surgical center.

Personnel

• Otolaryngologist or ENT (Ear, Nose, and Throat) surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Common Risks: Pain, dizziness, nausea, infection.
• Rare Risks: Facial nerve injury, taste changes, persistent hearing loss, cerebrospinal fluid leak.

Benefits

• Improved hearing ability.
• Relief from vertigo and tinnitus.
• Correction of previous surgical complications.
• Benefits may be realized several weeks after the procedure due to healing time.

Recovery

• Post-procedure Care: Patients may need to stay overnight in the hospital. Ear protection, avoiding water in the ear, and keeping the head elevated are crucial.
• Recovery Time: Generally, 2 to 4 weeks. Hearing improvements may take longer to fully assess.
• Follow-up: Follow-up visits with the surgeon to monitor healing and assess hearing outcomes.

Alternatives

• Other Treatments: Hearing aids, cochlear implants, continued monitoring without further surgery.
• Pros/Cons: Hearing aids are non-invasive but may not correct the underlying issue. Cochlear implants are another surgical option but are more invasive and typically reserved for more severe hearing loss.

Patient Experience

• During the Procedure: Patients will be under general anesthesia and will not experience any discomfort or sensations during the surgery.
• After the Procedure: There may be some discomfort or a feeling of fullness in the ear. Pain management, typically with prescribed pain relievers, is provided. Avoiding heavy lifting, straining, and sudden movements is advised to ensure proper healing.