Stapedectomy - DRHC Dubai ENT Clinic

How Stapedectomy Can Be Done?

To remove and replace the complete stapes (total stapedectomy) is rarely indicated nowadays because the chance to involve and make risk to the inner ear is more common than partial stapedectomy or stapedotomy, (like inner ear damage and adhesion between the graft and the vestibular contents). The procedure can be done under general or local anesthesia. Transcanal incision, posterior meatal skin flap including the eardrum should be dissected to explore the middle ear and ossicular chain (ear bones). Separation of the head of the stapes from the next ear bone (Incus) will be done, very tiny hole creation on the foot plate of the stapes fit to put piston instead of the stapes, and finally closing the meato-tympano flap.

Recommendation After Stapedotomy:

• Patient should stay quiet on the bed with head up for several hours up to 24 hours to reduce the vertigo, from the perilymph leak around the piston.
• Avoid blowing the nose strongly.
• Avoid lifting heavy things for several weeks.
• Avoid the head down position for several weeks.
• Advised not to travel by airplane for three months.
• The ear is blocked by ear pack , the ear pack should be removed after one week,

Indications and selection criteria for Stapedectomy are as follows:

• Good health to tolerate anaesthesia, especially if general anaesthesia is needed
• Conductive hearing loss due to fixation of the stapes, NO other disease.
• Presence of an air-bone gap of at least 30 dB across 3 frequencies confirmed with tuning-fork testing
• Good cochlear function by presence of good speech discrimination.
• The ear with poorer hearing should undergo the operation first. In bilateral cases, the second ear can be operated on 6 months later, assuming this is now the poorer-hearing ear.

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