Otosclerosis: When to consider stapedectomy surgery
Otosclerosis is a progressive condition that mainly affects the bones of the middle ear, resulting in hearing loss.
Mr Daniele Borsetto, leading consultant ENT surgeon, provides an expert insight into otosclerosis, including its causes, treatment, and when a stapedectomy is recommended.
Aetiology
Otosclerosis often runs in families. It follows an autosomal dominant pattern with incomplete penetrance, meaning not everyone who inherits the gene develops the condition.
When is surgery recommended for otosclerosis?
Surgery is an alternative to hearing aids in case patients wants to avoid using a hearing aid or don't get on well with a hearing aid.
In these situations, a stapedectomy/stapedotomy (the standard surgical procedure for otosclerosis) is recommended to help restore hearing.
How is a stapedectomy performed?
A stapedectomy is a highly specialised microsurgical/endoscopic procedure designed to improve hearing by replacing the immobilised stapes bone with a prosthesis. The surgery is performed under local or general anaesthesia.
During the procedure, your ENT surgeon will make a small incision in the ear canal to access the middle ear. The stapes bone will be carefully removed, and a prosthetic device, will be inserted to bridge the gap between the incus (another middle ear bone) and the oval window of the inner ear. This prosthesis will restore the connection between the middle ear and the inner ear, enabling the mechanical transmission of sound vibrations. The ear canal will be packed with a gauze that will need removal after normally 2 weeks.
The entire operation takes 30 minutes and is often done on an outpatient basis, meaning patients can go home the same day. In some cases, patients may require an overnight stay for observation.
What is the recovery process after a stapedectomy?
In the immediate post-op period, you may experience mild discomfort, dizziness, changes in taste, or a sensation of fullness in the ear. These symptoms will generally resolve within a few days to weeks. Any pain experienced is usually minimal and can be managed with over-the-counter pain relievers.
To facilitate recovery, you’ll be advised to:
- Avoid heavy lifting, strenuous activities, and sudden head movements.
- Refrain from flying or travelling to high altitudes for 6 weeks after surgery.
- Protect your ear from water until you see your surgeon for a follow-up, normally after 2 weeks.
Hearing improvement may not be immediate. Some patients notice better hearing within days, while for others, it may take several weeks for the full benefits to become apparent as the ear adjusts. This delay is due to swelling and the body’s natural healing processes.
The effectiveness of a stapedectomy is well-documented, with success rates of over 90%. Most patients experience significant improvement in hearing, enabling them to return to daily activities with greater comfort.
Rarely, complications such as persistent dizziness, tinnitus, or infection may occur. The chance of completely losing hearing during this operation is 1%. Close follow-up with your surgeon is essential to monitor healing and assess the prosthesis’ function.
Book an appointment with Mr Daniele Borsetto via his Top Doctors profile today.