When the stapes bone becomes “stuck” or “frozen,” a stapes operation is performed to improve hearing in a patient. One of the three bones in the middle ear, the stapes is the smallest bone in the human body. The stapes bone is required to hear, carrying the vibration of sound into the cochlea. But, if there is any malfunction to this hearing bone, conductive hearing loss occurs. Typically a “stuck” or “frozen” stapes bone occurs in patients who have otosclerosis, a condition that causes a buildup of bone around the stapes, preventing it from moving as it normally should. However, a “frozen” stapes bone can also occur from a severe middle ear infection, a traumatic incident, or it could be the result of a hereditary condition.
For years, the decisions regarding the surgical choice in stapes surgery have been conferred. What’s the better choice, a stapedectomy or stapedotomy? A stapedotomy is what Dr. Sperling primarily performs, which refers to a refined version of the early stapedectomy operation. Currently, the treatment of choice for otosclerosis is a stapedotomy. Many believe that the stapedotomy procedure is safer, simpler, and less traumatic than a stapedectomy.
Stapedectomy or Stapedotomy? What’s the Difference?
Compared to a stapedectomy, a stapedotomy includes the use of a laser to make a precise hole (fenestration) in the stapes footplate. While a stapedectomy typically removes the entire stapes footplate and has it replaced with a micro prosthesis. During a stapedotomy, a prosthesis is positioned within the precisely-made and measured hole that is created in the footplate of the stapes bone. The immobile stapes bone is replaced by the tiny, piston-like prosthesis, allowing the new prosthesis bone to move freely with the other middle ear bones, efficiently transferring acoustic energy to the inner ear.
What are the Benefits of a Stapedotomy?
• More precise procedure
• Decreased side effects
• Improved high-frequency hearing
• Safer and simpler than a stapedectomy
• Intraoperative complications are minimized
• Postoperative complications are minimized
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Frequently Asked Questions
A stapes bone can become stuck or frozen primarily due to otosclerosis, which causes abnormal bone growth around the stapes and restricts its movement. Other causes include severe middle ear infections, traumatic injuries, or hereditary conditions that affect the bone's mobility.
A stapedectomy involves removing the entire stapes footplate and replacing it with a micro prosthesis, whereas a stapedotomy uses a laser to create a precise hole in the footplate to insert a piston-like prosthesis. The stapedotomy is a refined, less invasive version of the stapedectomy.
Stapedotomy is considered safer because it is less invasive, involves more precise laser-created fenestration, and results in fewer intraoperative and postoperative complications. It also causes less trauma to the middle ear and improves high-frequency hearing better than stapedectomy.
The prosthesis replaces the immobile stapes bone by fitting into a small hole in the footplate, allowing it to move freely with the other middle ear bones. This restores efficient acoustic energy transfer from the middle ear to the inner ear, improving hearing.
Patients experiencing conductive hearing loss due to a frozen or stuck stapes bone—most commonly from otosclerosis—are candidates for stapedotomy. An evaluation by an ENT specialist is necessary to determine if the surgery is appropriate.
Benefits of stapedotomy include a more precise surgical approach using lasers, reduced side effects, improved high-frequency hearing, minimized intraoperative and postoperative complications, and an overall simpler and safer procedure compared to stapedectomy.