Stapedotomy is an operation to remove part of the fixed stapes bone (one of the bones in the middle ear) and replace it with a prosthesis (artificial device).

Why do I have to undergo this surgery?

You are experiencing hearing loss due to medical conditions (such as otosclerosis, which is the abnormal growth of bone around the stapes) that cause the stapes bone to become fixed and immobile. This results in ineffective conduction of sound from the external surroundings to the inner ear. This surgical procedure is an option to improve the hearing in the affected ear by replacing part of the fixed stapes bone with a prosthesis to restore effective sound transmission to the inner ear.

What does it involve?

This surgery will be done under local or general anaesthesia (a separate consent will be taken). Incisions (cuts) are made in front of the ear and/ or in the ear canal and the ear drum is then lifted to allow examination of the middle ear.

If the stapes bone is fixed, part of the stapes is removed and a fenestra (hole) is made in the stapes base plate (footplate) using either a laser or drill. In the event a fenestra cannot be made, a portion or the entire base plate of the stapes may need to be removed and replaced by a vein graft/ fascia graft (surgically implanted healthy blood vessels or connective tissue). The graft will be obtained from the surgical site or the back of the hand. If the graft is obtained from the back of your hand, a small incision (cut) will be made on the hand, which may cause minor scarring (~1cm).

A prosthesis is then placed into the fenestra or onto the graft, and secured onto the incus (another middle ear bone). The ear drum is then repositioned and the ear canal is filled with packing material.

The surgery may take around 1 to 3 hours.

The surgery may be abandoned if there is a high risk of complete hearing loss or facial nerve injury during surgery. If such an event occurs, you can discuss with your doctor about your options.