Stapedectomy is surgery to remove the stapes bone from the middle ear. The stapes bone helps transfer sound waves from the eardrum to the inner ear. A stapedectomy may be necessary when bone begins to fuse, causing hearing loss.

A stapedectomy is a surgical procedure to remove part of the stapes bones, one of three small bones in the middle ear.

The stapes bone helps transfer sound waves from the eardrum to the inner ear. Sometimes this bone begins to fuse with the surrounding bone and becomes fixed and immobile, causing hearing loss.

This article explains the purpose of stapedectomy, the procedure, recovery, risks, and more.

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The most common reason people need a stapedectomy is otosclerosis. This is when the stapes bone becomes fixed and cannot vibrate. It causes conductive hearing loss because sound waves cannot transmit easily through the eardrum.

Otosclerosis is a common cause of hearing loss in young adults. Most people who experience this condition notice hearing loss in their 20s and 30s.

A stapedectomy is an operation to remove part of the stapes bone, leaving the base that connects to the inner ear. A surgeon will use a drill or laser to make a tiny hole in the base to fit an implant, connecting it to the incus bone, which is another hearing bone. This can reverse hearing loss in most people.

Doctors recommend this surgery only when a person’s hearing loss is severe.

Learn how hearing works here.

The purpose of a stapedectomy is to improve hearing loss. After surgery, a person may not need to wear hearing aids. This can significantly improve a person’s quality of life.

The operation can also help with tinnitus, vertigo, and other symptoms of otosclerosis; improve balance; and reduce dizziness.

A stapedectomy is a fairly straightforward procedure to improve a person’s hearing. Below are the steps involved.

Before surgery

To prepare for surgery, people should consider the following:

  • Stop smoking, if applicable, to reduce the risk of complications and improve healing.
  • Exercise regularly, which will help improve recovery.
  • Ask the doctor about any medications or supplements they should stop taking before the surgery.
  • Speak with the doctor about possible risks and complications of the procedure.
  • Ask the doctor how any preexisting medical conditions may affect the surgery.
  • Arrange for someone to drive them home after the surgery if necessary.

During surgery

Doctors usually recommend a general anesthetic for a person undergoing a stapedectomy, but a local anesthetic is sometimes appropriate.

The surgery typically involves making a small cut in the front of the ear or around the outside of the ear canal. During the procedure, surgeons will replace the stapes bone with a prosthetic made of metal or plastic to transmit sound from the remaining bones into the inner ear.

After finishing the procedure, they will usually pack the ear with gauze to aid healing and prevent any bloody discharge from the ear.

The surgery typically takes about 1 hour, and people may be able to return home the same day.

After surgery

Most people’s hearing does not improve immediately, and it may take up to 4 weeks for a noticeable change to develop. Hearing can continue to improve for 2 months after the procedure.

People may find that their ear feels blocked or stuffy after the procedure, but this should resolve over time and after the doctor removes the packing material from the ear. They will usually remove the gauze 2–3 weeks after surgery, and some bloody fluid may discharge from the ear for a few days afterward.

Stapedectomy is typically an outpatient procedure, which means people do not have to stay in the hospital overnight. Most people can return to work within 3–4 weeks, but people should follow their doctor’s instructions on this.

Below are tips for improving recovery:

  • Avoid strenuous activity, bending, and sudden head movements. Gradually increase physical activity by walking a little more each day.
  • Avoid getting water in the ear after surgery, until a doctor advises otherwise.
  • Avoid air travel and contact sports until a doctor advises otherwise. These activities may prevent the ear from healing.
  • If taking prescription medication or over-the counter pain relievers, follow the instructions carefully.
  • Avoid blowing the nose for 2 weeks after surgery, or until a doctor advises otherwise.

Stapedectomy has a success rate of more than 90%, meaning that 9 in 10 people will experience a significant improvement in their hearing after the surgery. In the remaining 10% of cases, further surgery may be necessary.

If surgery is unsuccessful, people may need hearing aids.

In around 1 in 20 cases, surgery may worsen hearing. In 1% of cases, this could result in total hearing loss. This is why surgeons recommend operating first on the ear with poorer hearing.

Some complications may arise from a stapedectomy, including:

Most of these complications are temporary and should resolve within a few days if doctors treat them quickly. According to a 2019 study, serious complications occur at a rate below 1%.

Sometimes, a person’s hearing will not improve after surgery, so doctors may recommend further surgeries or hearing aids to assist.

Learn about hearing aid cost and pricing here.

Below are answers to some frequently asked questions about stapedectomy.

Is stapedectomy a major surgery?

Major surgery typically means a person receives general anesthesia and requires assistance with breathing. It also carries risks. Doctors consider this a major surgery.

How painful is a stapedectomy?

Typically, the procedure is not very painful. People may have some ear pain or a headache for several days afterward. Some people take pain medication for a couple of days after surgery to reduce discomfort.

A stapedectomy is a procedure surgeons perform to treat otosclerosis. This is when the stapes bone in the ear hardens and cannot move, or when there is abnormal bone growth inside the ear. It is a common cause of hearing loss.

During a stapedectomy, surgeons remove part of the stapes bone and replace it with a prosthetic, which is usually effective at restoring hearing.

Most people can return to work within a few weeks, but it may take up to 4 weeks to notice an improvement in hearing. During recovery, people should avoid strenuous activity, contact sports, getting water in the ear, and air travel.

The success rate of stapedectomy is around 90%, and the risk of serious complications is around 1%. For some people, the procedure may not restore hearing to an adequate level. In this case, they may need to wear hearing aids or undergo further surgery.