Stapedectomy

What is stapedectomy surgery?

Healthcare providers perform stapedectomy (stay-puh-dek-tuh-mee) surgery to restore your hearing. Stapedectomies repair middle ear damage caused by otosclerosis. This condition damages your stape, which is a tiny U-shaped bone in your middle ear that sends sound waves to your inner ear. Healthcare providers treat otosclerosis by replacing your stape with an artificial device.

Why would I need a stapedectomy?

You may need a stapedectomy if you have hearing loss caused by otosclerosis (oh-tuh-skli-roh-sis). This condition happens when your stape fuses with surrounding bone tissue, losing the flexibility it needs to transmit sound waves from your middle ear to your inner ear.

What are the otosclerosis symptoms?

If you have otosclerosis, you may notice that over time you’re having trouble hearing people when they whisper. You may have trouble hearing low-pitched sounds. You may be able to hear better when there’s lots of background noise. Some people with otosclerosis start speaking more quietly because they think their voice is too loud. Other possible otosclerosis symptoms include:

• Balance problems.
• Vertigo.
• Tinnitus (ringing in your ears).
• Dizziness.

Is stapedectomy a major surgery?

Generally speaking, a major surgery is an operation when you need general anesthesia and breathing support because you can’t breathe on your own. Given those parameters, stapedectomy isn’t a major surgery.

What happens before a stapedectomy?

Before you have a stapedectomy, your healthcare provider evaluates your hearing loss. Some steps your healthcare provider may take include:

• Obtain your medical history. They may ask how long you’ve had trouble hearing, if you have tinnitus or vertigo and if you have a family history of otosclerosis.
• Perform a physical examination. Your healthcare provider may check for acute or chronic ear infections. They may examine your ear canals and your eardrum (tympanic membrane.)
• Perform an audiometry. This test checks your ability to hear a range of tones. Your test results are displayed in an audiogram.
• Check your hearing loss by using a tuning fork to compare how well you hear sound through your bone and your ear. They do this by tapping the tuning fork and putting it on your mastoid bone behind your ear and then your ear.
• Check your eardrum with a handheld device called a tympanometer. This test is called tympanometry. Your test results are displayed in a tympanogram.
• Perform a computed tomography (CT) scan. This imaging test lets your healthcare provider look at the bones and tissues in your ear.

What happens during stapedectomy surgery?

Stapedectomies might be done as outpatient surgeries and last between 90 minutes to two hours.

If you’re having a stapedectomy, the steps your healthcare provider might take include:

• Administer anesthesia so you won’t have pain during the surgery. Stapedectomy can be done with local or general anesthesia.
• Use a laser or micro-instruments to access your eardrum. Sometimes, healthcare providers opt to make a small incision behind or in front of your ear to access your eardrum.
• Lift your eardrum to reach your middle ear bones.
• Remove your stape and replace it with an artificial device.
• Finish surgery by putting your eardrum back in place. Your healthcare provider places bandages or other material on your eardrum to hold it in place while your ear heals.

How painful is a stapedectomy?

You may have some mild pain or discomfort after your surgery. Ask your healthcare provider about over-the-counter pain medications you can take to ease your post-surgery symptoms.

What happens after this procedure?

You’ll be able to go home once you’ve recovered from anesthesia. You’ll need to rest for the first few days after your surgery. Most peoples’ ears heal after about six weeks. Here are some other things to expect after your stapedectomy:

• You may have some bloody discharge from your ear. If you do, gently place cotton balls in your ear to absorb the discharge.
• Your healthcare provider may prescribe antibiotic drops for your ear.
• You’ll need to keep your ear dry. If you take showers, put some Vaseline® on a cotton ball and put the cotton ball in your ear. Gently pat your outside ear area dry after your shower.
• You should avoid flying in airplanes until your ear heals. That may take four to six weeks. Flying puts pressure on your ear, and that pressure may dislodge your device.
• Don’t use earbuds until your ear heals.

Are there complications associated with treatment?

Like any surgical procedure, a stapedectomy carries the risk of complications. While the procedure helps about 80% to 90% of people with otosclerosis, it may not be successful in some cases. In rare instances, your hearing may even be worse after surgery. Some other potential complications include:

• Feeling dizzy immediately after your surgery and for the next few days.
• Losing your sense of taste on the side of your tongue. This symptom typically goes away after a few months.
• Developing tinnitus, or ringing in your ear.
• Your hearing may not improve or it may get worse after surgery. In some cases, your healthcare provider may recommend doing additional surgery. They may also recommend using hearing aids.

What are stapedectomy failure symptoms?

The most common failure symptoms for stapedectomy are hearing that doesn’t improve after surgery or additional loss of hearing.

What is the stapedectomy recovery time?

Most people who have a stapedectomy can return to normal routines in about one week. People whose jobs involve strenuous activity or heavy lifting may need to take additional time off.

Your healthcare provider may schedule a follow-up appointment one week after your surgery to check for vertigo or signs of infection. They may schedule another follow-up appointment four to six weeks after surgery to do hearing tests.

You should contact your healthcare provider if you have the following symptoms:

• Severe vertigo or dizziness.
• Unusual discharge, pain or swelling, which may be signs of infection.
• Bleeding that doesn’t subside after a few hours.
• The muscles on the side of your face where you had your surgery feel weak.

A note from Cleveland Clinic

Stapedectomies treat otosclerosis, a condition that damages your middle ear. You may not realize you have otosclerosis until you notice you can’t hear people when they whisper or speak softly. Stapedectomies are an effective way of treating otosclerosis and restoring your hearing. If you’ve been diagnosed with otosclerosis, ask your healthcare provider if a stapedectomy may be the solution to your hearing problem.