Stapedectomy Surgery in Hyderabad | Otosclerosis & Hearing Restoration

Q: What is otosclerosis and how is it diagnosed?

Otosclerosis is a progressive hereditary condition causing abnormal bone remodelling (otospongiosis) that fixes the stapes bone in the middle ear, blocking sound transmission to the inner ear and causing progressive conductive hearing loss. It typically presents in young adults — most commonly women — with gradual bilateral hearing loss often first noticed in the 20s and 30s. Diagnosis is clinical, based on: progressive conductive hearing loss on pure tone audiometry, intact tympanic membrane, absent stapedial reflexes on tympanometry, and characteristic Carhart's notch — in the context of a positive family history. High-resolution CT scan of the temporal bones may confirm otospongiosis. Contact SurgiPartner on +91 9030053009 for audiological assessment.

Q: How successful is stapedectomy for restoring hearing?

Stapedectomy (or stapedotomy) is one of the most successful hearing restoration surgeries in ENT. In experienced hands, 90–95% of suitable patients achieve closure of the air-bone gap to within 10dB — restoring hearing to near-normal levels. About 5% of patients experience no hearing improvement. The risk of significant worsening (profound sensorineural hearing loss / dead ear) is approximately 0.5–1% in experienced microsurgeons — this is why surgeon experience and case volume are critical selection criteria. SurgiPartner partners only with ENT otologists with specific middle ear microsurgery training and high stapedectomy case volumes.

Q: What is the difference between stapedectomy and stapedotomy?

Stapedectomy (the original technique) removes the entire stapes footplate and seals the oval window with a connective tissue graft before inserting a prosthesis. Stapedotomy (the modern preferred technique) creates a small precise perforation (fenestra) in the stapes footplate using a drill or laser, through which a piston prosthesis is inserted. Stapedotomy is superior because: it creates a smaller opening with less perilymph disturbance, reduces the risk of inner ear trauma, achieves equivalent hearing outcomes, and is the technique used at leading otological centres worldwide. Both terms are sometimes used interchangeably by patients.

Q: Is stapedectomy a painful operation?

No — stapedectomy is performed under local anaesthesia with sedation or general anaesthesia, and is not a painful procedure. Post-operatively, patients may experience mild ear discomfort for a few days, temporary dizziness or imbalance (from inner ear fluid disturbance resolving over 2–3 days), and altered taste on one side of the tongue (from chorda tympani nerve handling — usually resolves within weeks to months). Most patients describe the post-operative experience as very well tolerated. Hearing improvement is often noticed within days to weeks as the ear heals.

Q: Can stapedectomy be done on both ears?

Stapedectomy for bilateral otosclerosis is performed one ear at a time — with a minimum of 6–12 months between the two operations. This allows assessment of the first ear's result and full healing before operating on the second ear. The better-hearing ear is typically operated on second. Simultaneous bilateral stapedectomy is not recommended due to the rare but real risk of bilateral profound hearing loss if an adverse event occurs.

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Stapedectomy in Hyderabad — Hearing Restoration Surgery for Otosclerosis

Stapedectomy is a highly specialised microsurgical procedure to restore hearing in patients with otosclerosis — a condition where abnormal bone remodelling progressively fixes the stapes (the innermost and smallest bone in the human body) to the oval window of the inner ear, preventing sound transmission and causing progressive conductive hearing loss. In experienced hands, stapedectomy achieves hearing restoration to within normal or near-normal levels in approximately 90–95% of suitable candidates — making it one of the most gratifying procedures in all of ENT surgery. SurgiPartner connects patients in Hyderabad with ENT otologists with specific middle ear microsurgery expertise.

Understanding Otosclerosis — The Cause of Stapes Fixation

The normal stapes rocks back and forth at the oval window with each sound wave, transmitting mechanical vibration to the fluid of the inner ear (cochlea). In otosclerosis, abnormal remodelling of the endochondral (otic capsule) bone produces spongy, vascular bone (otospongiosis) around the stapes footplate. As this process progresses, the stapes footplate becomes progressively fixed — the vibration pathway is interrupted, and sound cannot enter the inner ear. The condition is bilateral in 70–80% of patients (though asymmetric) and affects women more commonly, often accelerating during pregnancy.

Symptoms Indicating the Need for Stapedectomy

Gradual hearing loss in one or both ears
Difficulty hearing low-frequency sounds clearly
Ringing or buzzing sound (tinnitus)
Sensation of ear blockage without pain
Hearing that worsens over time despite medications
Family history of otosclerosis

Audiological Features of Otosclerosis

Pure tone audiometry in otosclerosis typically shows: conductive hearing loss — air-bone gap of 25–60dB; preserved bone conduction thresholds (the inner ear sensorineural function is initially normal); a characteristic Carhart’s notch (a mechanical artefact causing apparent depression at 2000Hz on bone conduction); and type As tympanogram (reduced compliance from stiffened ossicular chain). Stapedial reflexes are absent on ipsilateral and contralateral stimulation — an important diagnostic finding distinguishing otosclerosis from other causes of conductive hearing loss.

Stapedectomy vs Stapedotomy — The Modern Standard

Stapedectomy (original technique) involves complete removal of the stapes footplate and replacement with a prosthesis resting on a connective tissue graft sealing the oval window. While effective, this creates a larger oval window opening with associated risk of perilymph fistula and inner ear trauma.

Stapedotomy — the current gold standard — involves drilling a precise small fenestration (0.6–0.8mm) in the stapes footplate using a hand drill, microdrill, or CO₂/Er:YAG laser, and inserting a piston prosthesis (titanium, fluoroplastic, or nitinol) through the fenestration. Advantages of stapedotomy over stapedectomy: smaller oval window opening, less perilymph disturbance, lower risk of sensorineural hearing loss, equivalent or superior hearing outcomes, and preferred technique at high-volume otological centres worldwide.

Laser Stapedotomy

CO₂ laser or KTP laser stapedotomy creates the footplate fenestration with non-contact laser energy — eliminating mechanical pressure on the inner ear during footplate drilling, reducing vibration-induced inner ear trauma, and providing a precisely sized perforation. Laser stapedotomy is considered the safest technique and is the preferred method at SurgiPartner’s partner otological centres in Hyderabad.

Frequently Asked Questions — Stapedectomy Hyderabad

What is otosclerosis and how is it diagnosed?

How successful is stapedectomy for restoring hearing?

What is the difference between stapedectomy and stapedotomy?

Is stapedectomy a painful operation?

Can stapedectomy be done on both ears?

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