Stapedectomy

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Stapedectomy

Stapedectomy is a procedure used for the removal of the stapes bone in the ear. The stapes bone is the third of the three tiny bones in your middle ear as well as the one closest to the inner ear.

Though it is the smallest bone in the body, it has an important role in translating movement from your eardrum to the fluids in the inner ear, which causes sound waves to be changed into nerve impulses that can be translated in your brain.

Sound causes the stapes bone to vibrate. This vibration eventually passes into the fluid of the inner ear which enables hearing. When the stapes bone is unable to vibrate, it can lead to a decrease or loss of hearing.

Purpose

One of the most common reasons why people go for a stapedectomy is due to otosclerosis. Otosclerosis is a growth of bone around the stapes that can prevent its vibration, which ultimately leads to loss of hearing. Therefore, this leads to the requirement of surgery so that hearing can be improved. A stapedectomy involves removing your damaged stapes bone and replacing it with an artificial one. Sometimes surgery can also be done to correct the bone if it is fractured or abnormally shaped.

Patients suffering from otosclerosis and significant hearing loss are usually considered candidates for this procedure. Before the procedure, patients need to undergo an audiometric test, as well as a consultation with the ear surgeon to determine how appropriate a stapedectomy is going to be for him/her.

Preparation

Before your procedure, it might be important to give up certain medications for some time, as they can lead to complications during the procedure or recovery period. Your doctor will discuss with you which medications you will need to avoid. Also, make sure that you do not start taking any new medications, supplements or herbs without first consulting with your doctor.

Arrange for a ride home after the procedure. It is likely that you will need help at home during your recovery period so it is best if you can arrange for someone to help you in this period as well.

On the night before your procedure, it is likely that your doctor will recommend you to eat a light meal and not to eat or drink anything after midnight unless your doctor tells otherwise.

Procedure

First, your surgeon might use general or local anesthesia, depending on your procedure as well as your overall health.

If general anesthesia is used, you will be asleep during the entire procedure. If local anesthesia is used, the surgery area will be numbed. You might also receive a sedative to help you relax.

The surgery will involve your surgeon removing all or part of the original stapes bone and replacing them with an artificial device. This will allow sound waves to be sent once again to your inner ear for hearing.

Your surgeon will perform your procedure through your ear canal and uses an operating microscope. Then the eardrum is lifted for exposing the middle ear bones. Once the stapes are removed, your doctor will place the artificial device. Then the eardrum is put back into its position to heal. Packing material which is later absorbed by your body is used to hold it in place.

The procedure generally takes around 90 minutes and the majority of patients are able to go back home the same day.

After the procedure

You will be kept and monitored in a recovery area until you are ready to go back home. In some rare cases, an overnight stay might be required though in most cases, patients should be able to go home the same day.

While you are at the hospital, the staff will take some steps so that they can reduce your chance of infection such as keeping your incisions covered.

Results

Most patients are able to experience better hearing immediately after the surgery, but might sometimes report things that may not be normal. The feeling of fullness in the ear should go away once the packing around the eardrum has been absorbed and fluid drains away. Full improvement can take around three to four months.

Make sure that you follow the instructions provided by your doctor or the healthcare team.
Call your doctor if you experience any of the following:

  • Signs of infection, including fever and chills
  • Discharge having a foul odor
  • Swelling, redness, increased pain, excessive bleeding or any green or yellow discharge from your ear

 

On average, 90 percent of patients usually have complete success from the surgery which can result in significantly better hearing. If inner ear functions are normal, it can result in the restoration of near-normal hearing.

Around seven percent of patients generally recover partial hearing after the procedure, while two percent of patients experience no change in the hearing level. There is also a chance that one percent of patients might experience worse hearing after the procedure.

Risks

Some of the few risks that are associated with this procedure include:

  • Dizziness or vertigo
  • Changes in taste
  • Sensitivity to loud noise
  • Tinnitus
  • Injury to your facial nerve
  • Infection

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