A stapedotomy is a small hole drilled and/or lasered in the footplate to facilitate placement of a prosthesis through the footplate. Surgery is considered successful if the air-bone gap is closed to 10 dB or less. In a large series with mobile malleus and incus, this was achieved in 94.2% of patients.
The arch of the stapes bone is removed. Any tiny blood vessels running over the footplate are 'cauterised' with the laser. This avoids possible bleeding into the inner ear when the hole is made. The gap between the incus bone and the footplate of the stapes bone is measured.
It is successful in restoring hearing in more than 90 percent of cases, and the gain in hearing is usually permanent.
Your hearing may improve right away. But often it takes about 2 to 4 weeks to notice a difference. Hearing often continues to improve in the 2 months after surgery. While you are healing, it's important to avoid getting water in your ear.
Otosclerosis is a hereditary ear condition whereby the third middle ear bone, known as the stapes, becomes stuck and cannot vibrate freely, as it is intended to do in order to transmit sound into the inner ear. This leads to a form of hearing loss called a conductive hearing loss. This bony process can also invade the inner ear capsule, resulting in another type of hearing loss known as sensorineural (nerve) hearing loss. Stapedotomy is a procedure that aims to replace the stapes bone with a prosthetic.
The approach into the middle ear is via a small incision above the ear canal called an endaural incision. The eardrum is lifted up and the middle ear is entered and explored. To replace the stapes, the top half of the bone is removed using a laser. Afterwards, a small opening is made through the footplate of the stapes again using a laser and a teflon piston-type prosthesis is used to reconstruct the defect.