Stapedectomy is a procedure to improve hearing by removing the stapes bone in the middle ear and replacing it with a prosthesis. The surgeon makes an incision in the ear canal lining and eardrum to expose the middle ear. They then remove the stapes bone and insert a prosthesis between the incus bone and inner ear to restore sound conduction. Possible risks include temporary facial nerve paralysis, eardrum tears, and taste or balance disturbances, but permanent issues are rare.

1. Stapedectomy

2. 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.

3. 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.

4. How is it performed?

5. 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.
.

6. 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
..Contd

7. ..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.

8. 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.

9. 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.

10. • 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
Contd..

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