An abnormal growth of extra bone in your middle ear (otosclerosis) can freeze a tiny bone called the stapes.
The stapes, also known as the stirrup bone, is one of three bones that are essential to hearing. It helps send sound vibrations to your inner ear.
If you have otosclerosis, the stapes can't move, causing hearing loss. A surgery called stapedectomy can help.
Not many otolaryngologists perform stapedectomy, which requires extreme surgical skill and years of experience.
University of Iowa Health Care otologists and neurotologists perform more of these surgeries than anyone else in Iowa. More than 90% of people who have a stapedectomy here regain their hearing after the procedure.
The UI Health Care approach to a stapedectomy
During a stapedectomy, an otologist (ear surgeon) removes all or part of the original stapes bone and replaces it with a prosthesis. This restores hearing by enabling sound waves to be sent once again to the inner ear.
How stapedectomy works
Your otologist will perform the procedure through your ear canal with the help of a precision microscope.
- They'll lift your eardrum to expose the middle ear bones.
- They'll create a small hole (fenestra) in the stapes using a laser to bypass the fixed portion. The last step is placing the prosthesis between the middle bone of the ear (incus) and stapes fenestra.
Your eardrum is returned to its normal position to heal, held in place by packing material that is later absorbed by the body.
What to expect
You'll receive a sedative and local anesthesia for your stapedectomy. This means you'll be relaxed but awake, with numbing medicine placed in your ear where the surgery takes place.
The procedure takes about 90 minutes. After it's complete, your otologist will check your hearing.
You'll probably be able to return home the same day. It's recommended that you avoid strenuous activity for about a week.
After your surgery
During and immediately after surgery, most people notice better hearing but say that things don't sound quite normal. This will improve over time.
You'll feel some fullness in your ear, which will go away once the packing around the eardrum is absorbed and fluid drains from your ear.
You'll continue to experience hearing improvement over the next three to four months.
Once your healing is complete, your hearing is likely to be significantly better. If your inner ear functions are normal, the result is restoration of near normal hearing.
Who gets otosclerosis?
Otosclerosis usually develops slowly, starting in one ear and often affecting both ears. The exact cause is unknown, but it often runs in families.
The disease causes conductive hearing loss, which makes low-frequency sounds like thunder hard to hear.
This is different from high-frequency hearing loss, which is caused by exposure to loud sounds and makes high-pitched sounds like whistling hard to hear.
Alternatives to stapedectomy
Some people aren't good candidates for stapedectomy, including those who:
- Have Meniere's disease
- Have an active ear infection
- Have functional hearing in only one ear, with total hearing loss in the other ear
If any of these apply to you, your otologist may recommend:
- Monitoring your otosclerosis through observation and further testing
- Being fitted with a hearing aid to amplify sound