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What is a Stapedotomy?

A stapedotomy is a surgery performed in the ear to improve hearing. It involves the creation of a precise hole in the footplate of the stapes, which is a bone in the middle ear; and the placement of a micro-prosthesis. The footplate of the stapes covers the opening to the inner ear and helps carry vibration of sound into the inner ear.

Indications for Stapedotomy

Stapedotomy may be indicated when there is a malfunction of the stapes bone that is caused by a condition known as otosclerosis, which is characterized by the formation of extra bone around the stapes preventing it from transmitting sound vibrations and resulting in loss of hearing.

Preparation for Stapedotomy

Specific instructions will be provided by your surgeon. In general, you should:

  • Inform your surgeon about any health conditions, allergies, and medications you are taking.
  • Avoid smoking as it will slow down the healing process.
  • Follow the pre-surgery dietary restrictions.

Stapedotomy Procedure

  • The procedure can be performed under local monitored anesthesia.
  • A numbing medication is placed inside the ear.
  • Using an operative microscope, an incision is made into the skin of the ear canal.
  • A skin flap and the eardrum are lifted.
  • Some amount of bone is removed to visualize the stapes footplate.
  • A precisely measured hole is made in the stapes footplate using a surgical micro-drill or laser.
  • The edges of the hole are trimmed to accommodate a special piston-like prosthesis.
  • The superstructure of the stapes is then removed with forceps so the prosthesis can move freely with the other bones of the middle ear to efficiently transfer sound vibrations.
  • The skin flap and eardrum are placed back in their original position and held in place with absorbable packing.
  • The procedure is usually completed in about 90 minutes.
  • Following the procedure, you will be moved to the recovery room for a short period of observation.

Recovery after Stapedotomy

  • You may require 1 to 2 hours to recover before being discharged home.
  • There may be temporary ear discomfort. Your surgeon will provide medications to alleviate symptoms as necessary.
  • Complete healing may take 4-6 weeks. Avoid getting the ear wet, manipulating the ear, or performing any strenuous activity during this period.
  • Keep your follow-up visits as recommended to ensure a positive surgical outcome.

Risks Associated with Stapedotomy

Stapedotomy is a very safe procedure that can help restore hearing and improve quality of life; however, as with any other surgery, there is a minimal risk of complications that include infection, bleeding, delayed healing, nerve injury, and decreased hearing.