Stapedectomy

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Stapedectomy
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What is Stapedectomy?

• Stapedectomy is a procedure performed on the
  middle ear to improve hearing. In this procedure
  the innermost bone (stapes) of the middle ear is
  removed, and replaced with a small plastic tube
  surrounding a short length of stainless steel
  wire called prosthesis. This helps in restoring
  more normal hearing.
• The Stapes bone is present in the middle ear
  which is involved in the conduction of sound
  vibrations to the inner ear, Stapedectomy is
  performed on the middle ear, this procedure does
  not require any incisions outside the body, as
  the entire procedure is performed through the ear
  canal. The procedure is performed under local or
  general anaesthesia, so that the patient does not
  feel any pain. The surgeon opens the ear canal
  and folds the eardrum forward. Using an operating
  microscope, the surgeon is able to see the
  structures in detail.

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Before the Procedure
Diagnosis is required for which certain hearing
tests have to be conducted by an ear specialist
(audiologist or otologist). Two most common tests
done for this are Weber's test and Rinne's test.
Apart from these CT scans or X-ray study of the
head may also be done to know more about it.
These tests are non-invasive and cause no pain.
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How is it performed?
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How is it Performed?
Your ear is divided into three parts, outer ear
which consists of pinna and auditory canal,
middle ear which consists of three bones
(Malleus, Incus and Stapes) and the inner ear
which consists of chochlea. Stapedectomy is
performed through the ear canal with the help of
specially designed microscope and instruments.
Your doctor will make an incision in the lining
of the auditory canal and will extend that to the
ear drum or tympanic membrane. The incision will
extend around the tympanic membrane to set it
free, and this allows it to be lifted and thus
leaves middle ear exposed.After exposing the
middle ear, your surgeon will scrape out the
extra bone tissue to clear the field of view
while ensuring no damage being done to the nerve
carrying taste inputs to your tongue. .
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Contd..

• Stapedectomy is performed through the ear canal
  with the help of specially designed microscope
  and instruments. Your doctor will make incision
  in the lining of auditory canal and will extend
  that to the ear drum or tympanic membrane. The
  incision will extend around the tympanic membrane
  to set it free and this allows it to be lifted
  and thus leaves middle ear exposed. After
  exposing the middle ear your surgeon will scrape
  out the extra bone tissue to clear the field of
  view while ensuring no damage being done to the
  nerve carrying taste inputs to your tongue

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Contd..
After exposing the middle ear your surgeon will
scrape out the extra bone tissue to clear the
field of view while ensuring no damage being done
to the nerve carrying taste inputs to your
tongue. After stapes has been exposed, your
doctor will use laser to set it free from Incus
and finally will also release it from its
footplate. Footplate helps in transmitting audio
signals from middle ear to inner ear. Your
surgeon will now make a hole in the footplate ,
the prosthesis will now be placed into the
footplate and the other end will be clipped to
incus (the middle bone). After the prosthesis has
been secured, your surgeon will put tympanic
membrane back to its previous position and will
secure its position with the help of absorbable
gelatin bandage.
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Recovery

• The patient is requested to follow the
  instructions given by the doctor It is extremely
  important that the patient must avoid getting the
  ear wet until it has completely healed. Water in
  the ear could cause an infection, which could
  lead to a complete hearing loss, therefore be
  cautious while taking shower, put cotton balls in
  the ear or wrap your ear by a plastic.
• The ear is quite sensitive right after the
  surgery, so the patient should avoid loud music
  until the ear retrains itself to hear sounds
  properly. The patient will also have some follow
  up appointments, it is recommended not to miss
  any of them.

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Potential Risks

• The goal of performing Stapedectomy is to give
  you the best hearing possible with the least risk
  of failure. But like other aspects of life, there
  are no guarantees of success. Possible risk
  factors could be
• Facial Nerve Paralysis The facial nerve controls
  movement on one side of the face and runs through
  the ear. A temporary paralysis occurs in less
  than 1 of patients after surgery. Permanent
  paralysis is very rare, occurring in less than 1
  out of 1,000 patients.
• Perforation In less than 10 of patients a small
  tear in the eardrum can occur. This normally
  heals without further difficulty.

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Contd..

• Taste Disturbance The nerve that supplies one
  third of the taste to the tongue runs through the
  middle ear and may have to be pushed aside or cut
  in order to do ear surgery. Therefore, temporary
  taste disturbance can occur.
• Dizziness Temporary dizziness, lasting up to a
  month, occurs commonly after Stapedectomy.
  However in less than 1 of patients, dizziness
  can be severe and long lasting

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