The stapes is a small bone in the middle ear, which plays a role in the conduction of sound from the outside to the inner ear. Occasionally it becomes fixed due to a disease process known as otosclerosis and, therefore, can no longer conduct sound. It then has to be removed or modified. This procedure is known as a stapedectomy or stapedotomy. A small prosthesis is used to replace the fixed stapes and restore the sound conductive mechanism in the middle ear. A hearing test, or audiogram, is needed prior to surgery to confirm that a conductive hearing loss is present.
The procedure for stapedectomy takes place under general anesthesia or IV sedation administered by our MD Anesthesiologist and takes approximately one to two hours. The procedure is typically done from within the ear canal, but in cases when the canal is narrow, an incision is made behind the ear to access the ear canal. The eardrum, or tympanic membrane, is carefully elevated from the surrounding canal, and the fixed stapes is carefully removed. The prosthesis is secured to the intact middle ear bones, or ossicles, and placed into proper position. The space around the prosthesis is filled with graft tissue harvested from a small incision behind the ear. The tympanic membrane is then placed back into its proper position.
After spending several hours in the recovery area, you will be discharged home. Pain associated with the procedure is typically mild, and is resolved by taking the prescribed pain medications. Do not be concerned regarding your hearing during the healing process. It takes 6 – 8 weeks before we can evaluate improvement and your hearing will be tested at that time. Bloody or watery drainage from the incision area may occur during the first 7 – 10 days. If this happens tape a piece of gauze over the area. Call the office if this persists longer than 10 days or if it develops an odor, swelling, or pain. Water should be kept out of the ear until it is healed. You may take a shower 2 days after the surgery provided you cover the ear with a cotton plug soaked in ointment and a shower cap to cover your head. The hair may be shampooed separately outside of the shower 3 days after surgery providing water is not allowed to enter the ear canal. Frequently there is a period of unsteadiness following surgery. This usually resolves within a few days. It is extremely rare for dizziness to persist. Ringing in the operated ear usually improves with surgery; rarely it may become worse during the postoperative period. Do not blow your nose with force for 2 weeks. If you sneeze, do so with your mouth open. Ear drops should be used as prescribed. No bending, lifting, straining aerobic exercise, heavy work or traveling until approved by your surgeon. DO NOT USE ASPIRIN OR IBUPROFEN PRODUCTS FOR 2 WEEKS POST-OP. No flying for 6 (six) weeks post operatively.
RISKS OF SURGERY
There are several risks associated with stapedectomy in Seattle. Stapedectomy in Seattle is an ear surgery procedure. One risk is the loss of hearing. The surgery has a very high success rate of significant hearing improvement (approximately 95%); however, there is a risk of no change in hearing (approximately 4 in 100), and a rare risk (1 in 100) of worsened hearing. Another risk is the return of a conductive hearing loss after a period of hearing improvement due to the progression of the otosclerosis disease process. This may necessitate revision surgery. Dizziness is common after surgery and is usually temporary, but on very rare occasions, the dizziness can be permanent. Another risk of surgery is alteration of taste. This occurs because the nerve which is responsible for taste on that side of the tongue runs on the undersurface of the tympanic membrane and may need to be manipulated to gain access to the stapes. The taste loss is usually temporary and typically recovers after several weeks. Damage to the facial nerve, which controls movement on that side of the face and lies in very close proximity to the stapes, is a very slight risk of this surgery. This can result in facial weakness; when this occurs, it is usually temporary and typically recovers after several weeks, but occasionally can be permanent. The incidence of postoperative infection is less than 5%. Infections are usually successfully treated with antibiotics. We perform various ear surgeries at our practice including Mastoidectomy and Tympanoplasty. If you want to contact us for more information, click here.
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