Stapedectomy

What is a stapedectomy?

A stapedectomy, also known as a stapedotomy, is a surgical procedure performed to improve your hearing by replacing the stapes bone in the middle ear with an implant made of metal or plastic.

The stapes bone is the smallest of the three hearing bones (ossicles) in your middle ear. The bones work together to transmit sound waves from your eardrum to your inner ear. Sometimes the stapes bone can get stuck and cannot move properly, it stops sound from passing through to your inner ear properly, which causes hearing loss. This type of hearing loss is known as conductive hearing loss.

This issue is often caused by a condition called otosclerosis. Otosclerosis occurs when abnormal bone growth fuses the stapes bone to other parts of your ear, reducing its movement and leading to hearing problems. 

What are the benefits of a stapedectomy?

A stapedectomy can help you hear better by letting sound travel properly through your middle ear again. This means you might not need a hearing aid, or you may not need it as much.

What happens during a stapedectomy?

A stapedectomy is usually performed under general anaesthesia (you'll be asleep), but local anaesthesia may be used to help with pain after the procedure.

During the procedure, your surgeon will remove the top part of the stapes bone, but leave the base, known as a footplate, which connects to the inner ear. They then create a small hole in the footplate using a tiny drill or laser and insert a small implant. This implant connects the incus (one of the middle ear bones) to your inner ear, helping sound travel properly again.

Sometimes, your surgeon may use a vein graft, usually taken from the back of your hand, to cover the hole in the footplate before the implant is placed. This helps to seal the hole in the footplate and provide a stable surface for the implant.

At the end of the operation, your surgeon may place a small dressing or packing in your ear canal to protect it while it heals.

Recovering after a stapedectomy

Before you leave the hospital, your consultant will provide instructions on how to recover safely and what to avoid during your recovery. 

Going home:
If you have general anaesthesia and go home the same day, you will need an adult to take you home in a car or taxi, and stay with you for at least 24 hours. Do not drive or operate machinery for at least 24 hours until you have full movement and coordination.

Keep your ear dry:
It is important to keep your ear dry while showering or bathing. Avoid swimming until your ear has fully healed, which usually takes around six weeks. Use a shower cap or cotton wool with petroleum jelly to protect your ear from water.

Avoiding pressure:
Try to avoid straining, lifting heavy objects, or engaging in intense exercise. If you have a physical job, you may need some time off work to allow your ear to heal and avoid sudden pressure changes that could affect your middle ear. Speak to your nurse or consultant if you need a fit note for your employer.

Sneezing and nose-blowing:
Do not blow your nose, and keep your mouth open when you sneeze to reduce pressure on your middle ear.

Flying:
 Avoid flying until your ear is completely healed, as changes in pressure can affect recovery. Your consultant will let you know when it is safe to fly again.

Potential complications of a stapedectomy

As with any surgical procedure, complications are rare but possible. Rest assured, your consultant will carefully assess the risks and advantages when deciding whether a stapedectomy is the right option for you. During your initial consultation, your consultant will also discuss any additional risks that apply to your situation.

Possible risks may include:

• Bleeding - during and after the procedure.
• Infection
• Hearing loss - hearing may get worse or be completely lost.
• Dizziness
• Tinnitus - the perception of ringing, buzzing or other sounds, even when no external sound is present.
• Change in taste - the nerve responsible for taste passes over the stapes bone and may be stretched or damaged.
• Weakness of facial muscles - the facial nerve passes through your middle ear and may be overheated by the drill or laser

If you experience any of these symptoms, please contact your healthcare provider or consultant immediately. They can assess your condition and provide the appropriate treatment.