This surgery is undertaken when we suspect a patient has otosclerosis. In this condition there is stiffening of the 3rd and final bone of hearing – the stapes bone. This means sounds are not efficiently transmitted to the inner ear, resulting in hearing loss.

Surgery involves lifting the ear drum to gain access to the middle ear (where the 3 bones of hearing are housed).

The diagnosis is confirmed.

A laser is used to make a 0.6mm hole in the smallest bone in your body (stapes).

An appropriately sized and purposively engineered piston is positioned into the hole and clipped onto the 2nd bone of hearing (incus). It allows sound to bypass the stiffened 3rd bone and so improves the quantity of sound transmitted to your inner ear.

The surgery does not reverse any damage your condition has done to the inner ear.

The surgery can improve the level and quality of hearing in 99% of people. More than 9 out 10 patients can be restored to within 10dB of their personal potential hearing. Each patient’s potential for hearing is different and depends on how healthy the inner ear is.

Stapedotomy is a safe procedure done frequently without any problems.

However, there are rare but potential risks of surgery that you should be aware of:

Whilst 99% of people report an improvement in hearing, 1% report no difference and of these, 1 in 200 patients can lose all their hearing following this surgery.

1 in 5 people complain of a metal taste on the tip of half their tongue following surgery. This is temporary. Permanent change in taste is very rare. If your taste is central to your career (e.g. chef or sommelier) please discuss this with your surgeon.

The effect of this surgery on tinnitus is unpredictable. Many patients report an improvement in their pre-existing tinnitus, some report no change and rarely patients report deterioration in their tinnitus.

Patients occasionally report temporary balance disturbance following surgery. Permanent change in balance is extremely rare.

This is a minor operation done in an operating theatre, with the patient awake but lightly sedated. We use local anaesthesia to ensure the procedure is completely pain free. There are no cuts involved in the surgery as it is all done through the ear hole. Once the piston is sited the patient’s hearing is restored and this is checked through verbal communication with the awake patient. The procedure lasts approximately an hour and most patients go home within 4 hours. Patients may feel a little dizzy following surgery, but this is temporary.

A pack is left in the operated ear for less than 2 weeks to reduce the risk of post-operative infections. You will need to place antibiotics drops on this for two weeks. Due to the pack patients often cannot hear effectively from this ear until we remove it in clinic. People who have surgery must keep their ears dry and avoid rapid air pressure changes (flights) for the first 2-4 weeks. People who have surgery traditionally take 1-2 weeks off from work depending on the physicality of their job.