Stapedectomy

Details of the middle and inner ear

The stapes is the third of three tiny bones in the middle ear and the one closest to the inner ear. Because of its shape, it’s sometimes called the stirrup.

While it’s the smallest bone in the body, it has the important role of translating movement from the eardrum to fluids in the inner ear, causing sound waves to be changed into nerve impulses that are translated in the brain.

When the stapes stops working

Otosclerosis is an abnormal growth of extra bone around the stapes. The growth causes the stapes to be frozen in place so it can’t vibrate as it should, resulting in hearing loss. Otosclerosis develops slowly, usually in both ears, and can run as a genetic trait in families.

Detail of Stapes

The procedure

Through a surgery called stapedectomy, a surgeon removes all or part of the original stapes bone and replaces it with an artificial device. The result allows sound waves to be sent once again to the inner ear for hearing.

The surgeon performs the procedure through the ear canal and uses an operating microscope. The eardrum is lifted to expose the middle ear bones. Once the stapes is removed and the artificial device is in place, the eardrum is put back into position to heal and is held in place by packing material that is later absorbed by the body.

The procedure takes about 90 minutes, and many patients are able to return home the same day.

The surgeon uses a local anesthesia to relax the patient but not put them completely to sleep. Numbing medicine is used in the ear where the surgery itself takes place. This approach allows the surgeon to check the patient’s hearing at the end of the operation.

The results

During and immediately after surgery, patients notice better hearing but report things may not sound normal. Usually the feeling of fullness in the ear goes away once the packing around the eardrum has been absorbed and fluid drains from the ear. Hearing improvement usually continues over the next three to four months.

Your care team will give you a set of instructions to follow after your surgery to make sure the surgical repairs are not harmed.

Typically, 90 out of 100 patients have a complete success from the surgery, resulting in significantly better hearing. If inner ear functions are normal, the result is restoration of near normal hearing.

Other outcomes, on average, include:

  • About seven out of 100 patients recover partial hearing from the procedure.
  • About two out of 100 patients have no change in hearing level.
  • There is a chance that one out of 100 patients will have worse hearing following the procedure.

Other risks or side effects from surgery include:

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

Alternatives to surgery

Instead of surgery, some patients and their doctors elect to

  • Monitor the condition through observation and further testing
  • Use a hearing aid to amplify sound
  • Use a medication like sodium fluoride to slow the progression of hearing loss
Last reviewed: 
April 2018
Alternative Names: 
Otosclerosis

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