TESTS AND PROCEDURES

Stapes Surgery

March 15, 2019

Stapes Surgery

Stapes surgery can improve conductive hearing. This surgery is done to replace all or part of a damaged (fixated) stapes bone. You will be given general anesthesia or local anesthesia with sedation during surgery. The surgery takes about 1 to 2 hours.

Cross section of ear showing outer, inner, and middle ear structures with damaged stapes.

Cross section of ear showing outer, inner, and middle ear structures showing instrument removing damaged stapes.

Cross section of ear showing outer, inner, and middle ear structures showing drill making hole in stapes footplate.

Cross section of ear showing outer, inner, and middle ear structures with prosthesis replacing damaged stapes.

A diseased stapes bone

The stapes bone may become affected by otosclerosis, an inherited middle ear disease. The disease creates spongy bone tissue. The tissue grows and hardens around the footplate (the part of the stapes that touches the inner ear). Hearing loss may result.

Removing bone

The first step of stapes surgery is removing the crura. This is the part of the stapes that touches the footplate. Your surgeon reaches the crura by going through the ear canal. An incision is made around the eardrum. The eardrum is held to one side. Then the crura is removed.

Preparing bone

The second step is preparing the diseased footplate for bone replacement. This will let sound vibrations reach the inner ear again. Your surgeon may make a hole in the footplate with a laser or drill. This is called a stapedotomy. Or all of the footplate may be removed and replaced with tissue. This is called a stapedectomy.

Replacing bone

The third step is replacing the crura. A manmade part (called a prosthesis) is attached to the incus bone. The prosthesis transmits sound waves to the inner ear. There are many types of prostheses. They are most often made of metal, plastic, or your own tissue. But some may use more than one of these materials.

Surgical complications

As with any surgery, this surgery has risks. You may still have some hearing loss that remains after surgery. In rare cases, the surgery can make hearing loss worse. Talk with your healthcare provider about any complications that this surgery has. 

Updated:  

March 15, 2019

Sources:  

Immediate postoperative nystagmus and vestibular symptoms after stapes surgery. Hirvonen T. Acta Oto-Laryngologica. 2013;133:842-45., Outcome measures in stapes surgery: postoperative results are independent from preoperative parameters. Koopman M. European Archives of Oto-Rhino-Laryngology. 2015;272:2175-81.., Stapes surgery: a National Survey of British Otologists. Lancer H. European Archives of Oto-Rhino-Laryngology. 2016;273:371-79., Taste function after stapes surgery. Guder E. Auris nasus Larynx. 2012;39:562-66.

Reviewed By:  

Ashutosh Kacker MD