What is the stapes bone?

The stapes bone is the innermost of the three hearing bones in your middle ear. The bones (ossicles) move together, transferring sound waves from your eardrum (tympanic membrane) to your inner ear. Sometimes the stapes bone can get stuck, and locks in place. This decreases the sound being carried across to your inner ear (conductive hearing loss). The problem is usually caused by otosclerosis, a condition that causes the stapes bone and bony capsule of your inner ear to thicken. The problem can also be caused by brittle bone disease.

What are the benefits of surgery?

Your conductive hearing loss should improve so you will usually not need to wear a hearing aid.

Are there any alternatives to surgery?

A normal hearing aid or sometimes a special bone-anchored hearing aid can often help you to hear better.

What does the operation involve?

The operation is usually performed under a general anaesthetic but a local anaesthetic can be used.

The operation usually takes an hour to 90 minutes and involves replacing the stapes bone with an implant made of metal or plastic.

Your surgeon will perform the operation either through a small cut in front of your ear or through a cut around your ear canal inside your ear.

Your surgeon will remove the top part of the stapes bone, leaving the base or footplate that connects to your inner ear. They will use a drill or laser to make a small hole in the base and then fit the implant, connecting it to the incus.

They may place a small pack in your ear canal.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• allergic reaction to the equipment, materials or medication
• venous thromboembolism (VTE)
• chest infection

Specific complications of this operation

• complete loss of hearing
• worse hearing
• dizziness
• tinnitus
• change of taste
• facial weakness
• infection of the surgical site (wound)
• allergic reaction to the pack material

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You may be able to go home the same day.

You should be able to return to work after about 2 weeks.

Do not blow your nose for a few days.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery with better hearing. You will need to come back after 2 to 3 weeks to have the pack removed.

Summary

Otosclerosis can cause the stapes bone to lock in place, causing conductive hearing loss. A stapedectomy can improve your hearing without the need for a hearing aid.

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