Otosclerosis and Stapedectomy
Otosclerosis is a disorder in which abnormal bone forms around the stapes — a tiny bone within your inner ear (cochlea). This abnormal bone growth prevents the stapes from vibrating properly, causing a decrease in hearing, sometimes in both ears. If left untreated, the hearing loss slowly worsens over time. Some people with otosclerosis also experience ringing in the ear and dizziness.
This disease, which is diagnosed by a hearing test and ear exam, is considered a hereditary disorder, as the tendency to develop otosclerosis is carried in the genes and is handed down from parent to child. Sometimes it skips generations, and not all family members are affected. The good news is that the patient population with otosclerosis is decreasing, but that also means it is critical to seek a physician with expertise in treating it.
Because Mount Sinai has been treating otosclerosis for many years and has a longstanding reputation for excellence, our Center for Hearing and Balance is a major referral hub for patients with otosclerosis. We treat a high volume of cases each year and have years of experience restoring patients’ hearing.
This is a view of the stapedectomy operation through the microscope. The surgeon makes tiny hole in the footplate of the stapes (arrow) using a micro-drill.
Stapedectomy — the surgical removal of the stapes and insertion of a prosthesis — was first introduced at Mount Sinai in the 1950s. At Mount Sinai we perform many stapedectomy operations each year, with excellent results. An alternative to stapedectomy is the use of a hearing aid. No medication has proven effective.
In stapedectomy, the doctor uses a microscope to see the small bones of the inner ear. Entering through the natural opening in your ear, your doctor makes an incision, moves your eardrum out of the way, and separates the stapes from the incus bone before removing the stapes.
A prosthesis made out of Teflon plastic is used to replace the stapes. The gain in hearing is usually rapid, and the prosthesis rarely fails. It is safe to have MRI scan after a stapedectomy operation.
Next we insert a prosthesis made of plastic or wire in place of the stapes. The prosthesis conducts sound vibrations to your inner ear, restoring hearing. Some fatty tissue, taken from a small incision behind the ear, will be used to seal the surgical opening. The eardrum is moved back into place at the end of the procedure.
The hearing usually starts to return about one week after surgery and can improve thereafter.
Stapedectomy is successful in restoring hearing in more than 90 percent of cases, and the gain in hearing is usually permanent. In a small number of cases, there is no improvement in hearing. There is a very small chance (~2 percent) that hearing will be lost to the point that a hearing aid may not be useful. Other risks include dizziness, which rarely lasts more than one week, and taste alteration, which usually recovers fully.
Patients usually leave the hospital the same day and are encouraged to rest at home and avoid strenuous work for one week after surgery.
The hearing usually begins to improve one week after the first post-operative visit. The gain in hearing is usually rapid and permanent, and the prosthesis rarely fails. It is safe to have MRI scan after a stapedectomy operation. Patients may fly in a plane three weeks after surgery.
Otosclerosis is a disorder in which abnormal bone forms around the stapes — a tiny bone within your inner ear. This abnormal bone growth prevents the stapes from vibrating properly, causing a decrease in hearing. If left untreated, your hearing slowly worsens over time.
Otosclerosis usually affects both ears to some extent. However, in some individuals, only one ear is affected. Along with hearing loss, some people with otoslerosis experience ringing in the ear and dizziness or imbalance.
Otosclerosis is a hereditary disorder. The tendency to develop otosclerosis is carried in the genes and is handed down from parent to child. Sometimes it skips generations, so not all family members are affected. It tends to affect females more than males. Otosclerosis can be diagnosed through a hearing test.