A stapedectomy is a surgical procedure to correct the conductive hearing loss caused by otosclerosis. In otosclerosis, the stapes (stirrup) has become fixed to the cochlea, the spiral bony capsule that contains the inner ear membranes. Using general or even local anesthesia in the operating room, the surgeon lifts up the eardrum and removes the damaged stapes with a small instrument or laser. An opening is made into the cochlea through the footplate of the stapes and a mechanical piston is attached to the incus (anvil). The eardrum is gently replaced. If the patient is awake, the improvement in hearing is immediate.
The probability of restoring normal hearing in carefully selected patients is 90%. However, there is a 1% chance of total deafness in the operated ear. Dizziness is another common complication after surgery. Postoperative pain is usually mild and recovery is brief. The operation typically improves hearing for 10 years or more, but sometimes requires repeating.
Otosclerosis is genetically mediated and probably also related to childhood measles. As a result of measles vaccination, otosclerosis has become quite rare in the United States. As a result, many American otolaryngologists have been trained to perform stapedectomy but rarely do this procedure in practice. Be sure to ask your surgeon about his or her recent experience and results with stapedectomy.
Hearing aids are an alternative to stapedectomy for most patients. Hearing aids may be recommended to a patient who is felt to be at increased risk for surgery, who has only one hearing ear, or who has sensorineural hearing loss that cannot be corrected by stapedectomy alone.