Stapedectomy

This surgical procedure is performed to treat deafness due to otosclerosis.  Otosclerosis is caused by fixation of the foot plate of stapes which prevents efficient sound transmission to the oval window.  The deafness caused is conductive in nature.

The surgical procedure is performed under local anesthesia.  Advantages of performing this surgery under local anesthesia are:

1. Improvement in hearing can be ascertained on the table.

2. Bleeding is minimal under local anesthesia. 

Indications for stapedectomy:

1. Conductive deafness due to fixation of stapes.

2. Air bone gap of atleast 40 dB.

3. Presence of Carhart's notch in the audiogram of a patient with conductive deafness.

4.  Good cochlear reserve as assessed by the presence of good speech discrimination.

Contraindications for stapedectomy:

1. Poor general condition of the patient.

2. Only hearing ear.

3. Poor cochlear reserve as shown by poor speech discrimination scores

4. Patient with tinnitus and vertigo

5. Presence of active otosclerotic foci (otospongiosis) as evidenced by a positive flemmingo sign.


Since a patient with otosclerosis is also an ideal candidate for hearing aid and surgery,  the patient must be properly counselled regarding the advantages and disadvantages of both.

This surgical procedure can be ideally performed under local anesthesia