Surgical Treatment for Otosclerosis
Stapedectomy
The conductive-type of hearing loss of otosclerosis is correctable by a highly successful surgery known as a stapedectomy. The surgery can be performed in the operating room either under local anesthesia with intravenous sedatives or under general anesthesia. Stapedectomy is a very delicate procedure performed under high power magnification using an operating microscope made specifically for ear surgery. The operation is performed entirely through the ear canal. A tiny incision is usually made on the back of the ear for the purpose of obtaining a tissue graft. This incision is hidden behind your ear and not visible.
The operation consists of elevating the eardrum and inspecting the hearing bones directly. The immobile, fixed stapes bone is then removed and a hole is made in the footplate using a highly precise laser. Once the stapes is removed, the oval window is sealed with a tissue graft, and a tiny prosthetic stapes is put into position, connecting the other hearing bones (the malleus and incus) with the oval window. The eardrum is repositioned and absorbable sponge packing is placed into the ear canal.
After healing has occurred following surgery, sound waves travel down the ear canal and touch the eardrum which moves the new, mobile hearing bone mechanism and allows the patient to hear once again. The prosthetic stapes hearing bone that is placed vibrates as the eardrum moves with sound and causes the fluid of the inner ear to move and stimulate the tiny nerve cells that allow us to hear.
The surgical procedure is performed in the outpatient setting and patients go home later that same day. Since the inner ear contains the balance organs, dizziness rarely can occur. Nose blowing, heavy lifting, straining and flying are prohibited in the first few weeks following a stapedectomy.
Hearing improvement is typically noticed when the patient returns to the office to have the packing removed from the ear canal. Many patients note a significant improvement at this point that continues to improve for weeks and months after the surgery. It is not uncommon for patients to note that running the faucet sounds like they are hearing a waterfall. The brain sensitivity to the new sounds that the ear can now hear improves over time and it becomes the “new normal”. Stapedectomy is highly successful in 95% of patients.
