Stapedectomy
Definition
A stapedectomy is the removal of the stapes bone in the ear. The stapes is a bone in the middle ear, it plays an important role in hearing.
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Reasons for Procedure
Sound causes vibrations of the stapes bone. The vibrations pass into the fluid of the inner ear which allow you to hear. If the stapes bone cannot vibrate hearing will be decreased or lost.
Otosclerosis is a common reason for a stapedectomy. Otosclerosis is a growth of bone around the stapes that prevents the vibration of the stapes bone and leads to hearing loss. Surgery is required to improve hearing. A stapedectomy removes the damaged stapes and replaces it with an artificial one.
The surgery may also be done to correct a stapes that is fractured or abnormally shaped.
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Excess bleeding
- Adverse reaction to anesthesia, such as light-headedness and wheezing
- Infection
- Damage to the ear
- Ringing in the ear ( tinnitus)
- Nausea and vomiting
- Hearing worsens
- Hearing loss
- Facial paralysis or twitching
- An impaired sense of taste
- The need for repeat surgery
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
What to Expect
Prior to Procedure
Before the surgery, your doctor may have images taken.
Leading up to your procedure:
- Certain medications may cause complications during the procedure or recovery. These medications may need to be stopped up to 1 week before the procedure. Talk to your doctor before the procedure about all medications you are taking.
- Do not start any new medications, herbs, or supplements without talking to your doctor.
- Arrange for a ride home from the procedure.
- Arrange for help at home as you recover.
- The night before, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
Anesthesia
Anesthesia may be general or local. The type of anesthesia used will depend on your procedure and general health.
With general anesthesia, you will be asleep throughout the procedure.
Local anesthesia will numb the area but you will be awake. You may also be given a sedative to help you relax.
Description of the Procedure
Special tools are used through the ear canal to access and view the middle ear. The eardrum will be gently lifted to allow access to the stapes bone. The stapes bone will be removed. Sometimes a laser is used to destroy parts of the bone and the remaining pieces are removed.
An artificial stapes replacement will be put in place. Once the new device is secure, the eardrum will be put back into place. A cotton or ointment plug may be placed in your ear canal. This packing will help keep the eardrum in place and protect the new stapes bone until it can set.
How Long Will It Take?
About 1 hour
Will It Hurt?
Anesthesia will help block pain during the procedure. You may feel occasional sharp, shooting pain in your ear after the procedure. The doctor will recommend medication to help manage any pain.
Post-procedure Care
At the Care Center
You will be monitored in a recovery area until you are ready to go home. Most will go home the same day but some may need to stay overnight.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Keeping your incisions covered
At Home
Certain activities will be limited to allow your ear to heal properly:
- Recovery may require up to a week off of work, especially of the work is physically demanding.
- Air travel will be limited for about 1 month.
- Swimming may be limited during the first few weeks to prevent getting water into the ear.
Home care will also be required to prevent putting too much pressure on the healing stapes.
Call Your Doctor
Call your doctor if any of these occur:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any yellow or green discharge from the ear
- Discharge that has a foul odor
- Nausea and/or vomiting that you can't control with the medications you were given after surgery, or which last for more than 2 days after discharge from the hospital
- Pain that you can't control with the medications you've been given
- Lightheadedness that lasts more than 3 days after surgery
If you have an emergency, call for medical help right away.
RESOURCES:
American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org
Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org
CANADIAN RESOURCES:
Canadian Society of Otolaryngology—Head and Neck Surgery
http://www.entcanada.org
Health Canada
http://www.hc-sc.gc.ca
REFERENCES:
Otosclerosis and stapedectomy. Michigan Ear Institute website. Available at: http://www.michiganear.com/ear-services-otoscierosis-and-stapedectomy.html. Accessed August 29, 2017.
Post-operation expectations. Ear Surgery Information Center website. Available at: http://www.earsurgery.org/surgery/stapedectomy/post-operation-expectations. Accessed August 29, 2017.
Stapedectomy. Marshfield Clinic website. Available at: https://www.marshfieldclinic.org/MedicalSpecialties/Pages/Stapedectomy.aspx. Accessed August 29, 2017.
Stapedectomy (surgery for otosclerosis). Baylor College of Medicine website. Available at: https://www.bcm.edu/healthcare/care-centers/center-hearing-balance/procedures/stapedectomy. Accessed August 29, 2017.
Surgery for otosclerosis: postoperative instructions. Hartford Hospital website. Available at: https://hartfordhospital.org/File%20Library/Services/Hearing/POST-OP-Stapedectomy.pdf. Accessed August 29, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 03/04/2016