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What is stapedectomy?

Stapedectomy surgery is a minimally invasive surgery performed if the patient has hearing loss due to sclerosis or damage of the tiny U-shaped stapes (stirrup bone) in the middle ear. The surgery involves complete removal of the stapes and insertion of a prosthesis to emulate the motion of a functional stapes bone and restore the patient’s hearing.

It is most commonly performed due to otosclerosis, a disorder in which the stapes bone gets fixed due to abnormal bone tissue formation around the stapes. This prevents the bone from vibrating – and amplifying the sound waves – leading to a decrease in the hearing ability in one or both ears.

Since hearing loss due to otosclerosis is very slow and gradual, most patients don’t notice it or get any treatment till the condition has gotten worse, which can complicate the treatment. If you have any hearing problems, get in touch with an ENT specialist immediately.

USFDA Approved Procedures

USFDA Approved Procedures

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No Cuts. No Wounds. Painless*.

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1 Day Procedure

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Best Doctors For Stapedectomy

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Pristyn Care hospitals for Stapedectomy

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  • 4/5
    Pristyncare Clinic image : Infinity Mall, Mum, Twinkle Apartments Adarsh Nagar Rd Andheri West...

    Pristyn Care Andheri West

    Infinity Mall, Mum, Twinkle Apartments Adarsh Nagar Rd Andheri West...

  • 4/5
    Pristyncare Clinic image : No A 24  Hauz Khas Delhi Delhi - Delhi

    Pristyn Care Hauz Khas

    No A 24 Hauz Khas Delhi Delhi - Delhi

  • 4/5
    Pristyncare Clinic image : Chanakyapuri Building tukaram paduka chowk 1st floor tukaram paduka chowk...

    Pristyn Care tukaram paduka chowk

    Chanakyapuri Building tukaram paduka chowk 1st floor tukaram paduka chowk...

  • 4/5
    Pristyncare Clinic image : KHB Colony, 5th Block 17th B Main Rd, Koramangala Bangalore...

    Pristyn Care Koramangala

    KHB Colony, 5th Block 17th B Main Rd, Koramangala Bangalore...

Best ENT clinics for stapedectomy

Best ENT clinics for stapedectomy

Pristyn Care is the best treatment center for advanced USFDA-approved minimally invasive surgeries for a variety of ENT problems, including stapedectomy. It is one of the largest and finest surgery providers in India. 

Pristyn Care has expert ENT specialists with plenty of expertise and experience in dealing with ear problems conventionally and surgically. Moreover, it is partnered with the best ENT hospitals and clinics in most major Indian cities for advanced treatment.

Pristyn Care also provides auxiliary services to all patients, including free consultations, complimentary cab and meal services, and many more. Contact us and book a free consultation with the top ENT doctors near you right away.

Which diagnostic tests are necessary before stapedectomy?

Which diagnostic tests are necessary before stapedectomy?

If you are experiencing any degree of hearing loss, you should undergo the following diagnostic tests to determine the cause of hearing problems and the appropriate treatment for it. The diagnostic procedure generally begins with a medical history and physical examination. 

Otosclerosis is a hereditary disease and patients who have a family history are more likely to suffer from the condition. During physical examination, the ENT specialist will look in the ear canal using an endoscope to determine whether the patient’s symptoms are due to an infection, sclerosis, trauma, etc. If the patient has otosclerosis in both ears, the ear with worse hearing is operated first.

The ENT may suggest the following hearing tests to determine the severity of hearing loss in the patient:

  • Audiometry helps test hearing ability in a range of tones.
  • Tuning fork test helps determine how well the sound is transmitted through the middle ear bones and the mastoid.
  • Tympanometry helps assess the movement of the eardrum to determine if the hearing problems are a result of tympanum trauma or deformity.

Diagnostic tests also commonly required before a stapedectomy include imaging tests like CT scan, X-ray, etc., as they help the ENT to visualize the internal structures and learn about the extent of the sclerosis to finalize the best type of prosthesis for the patient.

What happens during a stapedectomy?

What happens during a stapedectomy?

Generally, for mild otosclerosis, most ENT doctors prefer a watchful waiting approach or hearing aids. While hearing aids can’t reverse the damage due to otosclerosis, they can aid the patient’s hearing ability before the progression of the disease.

If the patient has severe hearing loss, the doctor may recommend a stapedectomy surgery. In advanced modern surgeries, local anesthesia is preferred to perform the surgery, so it is an outpatient procedure and the patient can avoid anesthesia-related complications.

The ENT surgeon may use a laser or microscopic instrument to lift the tympanum and gain access to the middle ear. Then the required part of the stapes is removed and a prosthetic device is fitted in its place. 

Finally, the ear canal is packed and bandaged to keep the eardrum and prosthetic in place and aid in the patient’s recovery post-surgery. Complete surgery may take around 90 minutes to 2 hours.

How to prepare for the surgery?

How to prepare for the surgery?

Before undergoing a stapedectomy, the patient should be completely aware of the pros and cons of the surgery. There is a very slight chance that the patient may have permanent sensorineural hearing loss after the surgery, so they should be prepared for that. Patients should also be advised properly regarding postoperative recovery so they can avoid complications.

Some general preparative measures the patient can take before the surgery are:

  • Stop smoking at least a couple of weeks before your surgery is scheduled as tobacco decreases the recuperative ability of the body.
  • Maintain a healthy weight and diet. Perform mild to moderate exercise.
  • If you have any pre-existing conditions then get approval for the surgery from your general physician/primary care provider.

When is stapedectomy required?

When is stapedectomy required?

As discussed above, most patients are suggested stapedectomy for treatment of otosclerosis, i.e., the fusion of stapes with the surrounding bone. Other indications of stapedectomy are:

  • Conductive hearing loss
  • Airborne gap of at least 30dB
  • Good cochlear reserve demonstrated by good speech discrimination
  • Tympanosclerosis
  • Osteogenesis imperfecta 
  • Paget’s disease

Common symptoms for which stapedectomy may be necessary are:

  • Trouble hearing low-pitched sounds, especially when someone is whispering
  • Balance issues
  • Vertigo
  • Tinnitus – ringing sound in the ears
  • Dizziness

Mild symptoms are usually managed conservatively, but in severe cases, the patients may need surgery for relief. In children,  stapedectomy may be required for congenital stapedial fixation, or juvenile otosclerosis.

How can stapedectomy benefit you?

How can stapedectomy benefit you?

Patients with hearing loss due to otosclerosis can benefit from stapedectomy, as it can reverse the hearing loss, or enable them to use hearing aids. In children, stapedectomy is especially beneficial over conservative treatments as it prevents the long-term effects of pediatric hearing loss without impeding their activities or increasing the risk of future hearing loss.

When is a stapedectomy not recommended?

When is a stapedectomy not recommended?

There are some cases in which a stapedectomy is not recommended, such as:

  • Patient already has complete hearing loss in one ear
  • Patient has severe swelling and fluid buildup in the ear
  • Presence of active otosclerotic foci (otospongiosis) as evidenced by a positive Schwartz sign/Flemingo’s pink sign
  • Conductive deafness due to Ehlers-Danlos Syndrome (EDS)
  • Patient has a severely retracted eardrum
  • Diabetes or other medical problems
  • Mild hearing loss
  • Active ear infection
  • Deformity in the inner ear
  • Pregnancy
  • Patients with high risk of future head injuries like boxers, wrestlers, etc.

Frequently Asked Questions

Is stapedectomy covered under insurance?

Yes, stapedectomy is generally covered under insurance as it is a medically necessary procedure. However, to be sure, you should check the terms of your policy or connect with your insurance provider.

Which surgery is better- stapedectomy or stapedotomy?

During a stepdotomy, the surgeon uses a laser to make a precise hole in the stapes bone to insert an implant, and then replaces the immobile part of the stapes with a piston-like implant. Since the surgery does not entail the removal of the entire stapes bone, it provides better recovery, hearing ability, and lower risk of complications. Therefore, most surgeons nowadays prefer stapedotomy over stapedectomy.

Are hearing aids better for otosclerosis than stapedectomy?

Most people consider hearing aids better as they do not require surgery, however though hearing aids improve the hearing ability, they do not treat the underlying condition. Therefore they are not preferred for patients with progressive hearing problems.

How long does the patient have to avoid swimming after a stapedectomy?

Patients have to avoid submerging their ears under water for at least four to six weeks, so they can start swimming after that with doctor’s approval.

Which sleeping position is best after stapedectomy?

While sleeping, the patient should use 2-3 pillows to elevate the head while sleeping, or sleep in a reclining chair to keep the head elevated. This helps reduce postoperative swelling and aids recovery.

Will the prosthesis be removed in the future?

No, generally stapedectomy prosthetics are permanent and don’t need to be removed. However, if the patient needs a revision stapedectomy, the implant may be removed and replaced with another implant. 

What to expect after the stapedectomy?

What to expect after the stapedectomy?

Generally, it takes about 3-4 weeks for the patients to have noticeable improvement in hearing, so do not panic if there is no difference in hearing immediately after the surgery.

Most patients have mild pain or discomfort after the surgery for a few days. Normally, over-the-counter pain medications are enough to soothe the patient’s pain, but if the patient has severe pain, it may be a sign of postsurgical complications, and the patient should consult their doctor immediately.

Most patients are able to go home on the same day nowadays, and are suggested rest and very light activity for the first few days. Complete recovery can take upto 6 weeks, but most patients can return to daily life activities much before that. 

There may be a little bloody discharge in the first couple of days, you can place small cotton balls in the ear to absorb it. If there is any sign of infection, your surgeon may advise antibiotic drops to avoid it. 

Some patients may also have unsteadiness, numbness around the ear, and popping, clicking or pulsating sounds in the ear for the first few days. 

After the surgery, patients have to avoid straining the ear canal so they must – not lift heavy weights, avoid staining while coughing or sneezing, and avoid inserting anything in the ear canal- till they have completely recovered.

What are recovery tips for stapedectomy surgery?

What are recovery tips for stapedectomy surgery?

Most patients can resume work and their daily life within 1 week, if they have a desk job or lead a sedentary  lifestyle, but they have to wait at least 3-4 weeks before performing strenuous activities, heavy lifting, exercises, running, etc. 

Some tips that you should follow to improve recovery after stapedectomy surgery are:

  • Keep your ear dry, especially before your eardrum has completely healed. While bathing or showering, close the ear canal using a silicone plug or cotton ball covered by Vaseline. Once you’re done, remove the cotton ball and clean the outer ear region using a cotton ball.
  • Avoid flying until your ear has completely healed, as the air pressure changes while flying can dislodge the prosthesis. Most patients are eligible to fly around 3 weeks after the surgery.
  • Don’t use earbuds until the ear has healed. If you want to, you can get approval from your ENT for over-the-ear earphones.
  • You can resume a normal diet immediately, but if you have an upset stomach or constipation, you should eat healthier low-spice foods to avoid straining.
  • Drink plenty of water and electrolytes to maintain hydration and take your medicines as prescribed.

What are the complications associated with stapedectomy?

What are the complications associated with stapedectomy?

While 80-90% of people do not have any complications after the surgery, in rare cases, the patient may suffer from complications. Most stapedectomy complications disappear within a few days on their own or can be managed if diagnosed in time, but if not, they can result in severe hearing loss. Some potential complications of stapedectomy are:

  • Failure of the treatment
  • Worsening of the hearing after the surgery
  • Severe dizziness or lightheadedness lasting more than 3 days
  • Nerve irritation or damage leading to loss of taste or altered taste sensation in the operative side of tongue
  • Development of tinnitus
  • Loss of hearing regarding high frequency sounds
  • Facial palsy
  • Eardrum perforation

Absence of improvement in hearing and additional loss of hearing are the most common signs of treatment failure. You should consult a doctor immediately if you exhibit the following symptoms:

  • Severe vertigo, dizziness, or balance problems
  • Signs of post-surgery infection, like heavy pain, bleeding, discharge, or swelling
  • Muscle weakness or loss of sensation on the operative side

The patient’s ears may be noise sensitive during the first few days, so they should avoid pubs, concerts, and other noisy areas. They should also avoid activities like swimming, contact sports, scuba diving, etc., till they have received approval from the doctor.

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