question-icon

How is stapedectomy performed?

default
Posted on Mon, 21 Jul 2014
Question: when a stapedectomy is performed is the pt normally secured or physically restrained to prevent pt movement during the procedure which could possibly cause surgical complications or trauma while the procedure is performed in the microscopic area of the inner ear ?
doctor
Answered by Dr. Sumit Bhatti (51 minutes later)
Brief Answer:
No. You also have other options.

Detailed Answer:
Hi,

Thank you for your query.

1. It is not necessary to physically restrain a patient during stapedectomy.

2. A stand-by anesthetist usually delivers a judicious dose of sedation, anti-anxiety medication and pain killers to calm the patient.

3. This is besides the local anesthesia infiltration used. Under local anesthesia, the patient is aware of touch, but no pain is felt. Sounds can be heard, communication is possible.

4. At the most and depending upon the circumstances, some surgeons may request their assistant to stabilize the patients head gently but firmly while working under the microscope in the middle ear. The use of an endoscope is also possible now.

5. It is also not true that surgery is the only option. Besides the stapedectomy you may:
a. Do no treatment if your hearing loss is mild.
b. Wear hearing aids.
c. Get a Baha (Bone Anchored Hearing Aid) softband or surgically fitted if you have a moderate conductive or mixed hearing loss. This involves an operation on the skull above and behind the ear and not in the ear. Lifestyle changes after a stapedectomy can be avoided.

6. Advanced Otosclerosis usually involves the cochlea and causes a mixed hearing loss. This is where a stapedectomy may not help as it would have at a younger age.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (2 hours later)
Hello Dr. , Thank you for your detailed reply. I must be honest with you and tell you the complete story. In 1984 I had stapes surgery on the right ear, a general anesthetic was used. In 1985 the procedure was performed on the left. I was told prior to the surgery that a different anesthesia would be used as my heart rate dropped into "the 30s" and I was given atropine. I was 35 years old at the time and a runner ,45-60 miles a week, it was not unusual for my pulse to drop below 50 at rest. During the 2nd surgery with the local anesthetic I woke and sat up forcefully in a complete fog.Since that event I have had painfully severe tinnitus, further hearing loss,physical ear pain, and increased vertigo. I have looking for some relief since without success. I do use hearing aids. I have tried a masker but find no help as the tinnitus is much louder and intense. Any thoughts? Thank You.
doctor
Answered by Dr. Sumit Bhatti (17 hours later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

Hi,

Thank you for your query.

1. A recent Pure Tone Audiogram (PTA) and an Impedance Audiogram (Tympanogram) will be of immense help.

2. 'Recruitment' is a phenomenon that gives rise to an abnormal increase in loudness of high pitched sounds when intact hair cells next to damaged hair cells are 'recruited' for hearing. This may explain why the Tinnitus becomes much louder and intense when using a Tinnitus masker. Try Widex XXXXXXX Therapy.

3. Cochlear Synaptic Tinnitus may be treated in up to 50% people with Caroverine infusion followed by capsules for two months. Other treatments such as transtympanic steroids, Hyperbaric Oxygen (HBOT), gingko biloba, multi-vitamins and anti-oxidants may also help in reducing Tinnitus.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (1 hour later)
Hello Dr., Thank you for your prompt and thoughtful reply. You've provided me with information that has never been offered before. I cannot help but wonder why this is the case given that I have asked many times before. Once again I apologize for not providing the actual facts initially. I hope you may understand that it has been difficult to obtain answers to my questions. Also that from my point of view this situation has provided significant quality of life issues. Thank You Sir.
doctor
Answered by Dr. Sumit Bhatti (7 minutes later)
Brief Answer:
Thank you.

Detailed Answer:
Hi,

Thank you for writing back.

1. This form of consultation has its own merits and pitfalls.

2. I would appreciate a follow up in future. Hope this helps improve your QOL issues.

Wishing you good health,

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2658 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

199 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
How is stapedectomy performed?

Brief Answer: No. You also have other options. Detailed Answer: Hi, Thank you for your query. 1. It is not necessary to physically restrain a patient during stapedectomy. 2. A stand-by anesthetist usually delivers a judicious dose of sedation, anti-anxiety medication and pain killers to calm the patient. 3. This is besides the local anesthesia infiltration used. Under local anesthesia, the patient is aware of touch, but no pain is felt. Sounds can be heard, communication is possible. 4. At the most and depending upon the circumstances, some surgeons may request their assistant to stabilize the patients head gently but firmly while working under the microscope in the middle ear. The use of an endoscope is also possible now. 5. It is also not true that surgery is the only option. Besides the stapedectomy you may: a. Do no treatment if your hearing loss is mild. b. Wear hearing aids. c. Get a Baha (Bone Anchored Hearing Aid) softband or surgically fitted if you have a moderate conductive or mixed hearing loss. This involves an operation on the skull above and behind the ear and not in the ear. Lifestyle changes after a stapedectomy can be avoided. 6. Advanced Otosclerosis usually involves the cochlea and causes a mixed hearing loss. This is where a stapedectomy may not help as it would have at a younger age. I hope that I have answered your queries. If you have any further questions, I will be available to answer them. Regards.