The operation is commonly called a stapedectomy or more correctly a stapedotomy. This operation has traditionally been carried out under a local anaesthesia.
Using an operating microscope the surgeon lifts up the eardrum. Often a small amount of bone needs to be scraped away to get a clear view. At this stage, it is important to confirm the diagnosis and check that it is otosclerosis that is causing the problem. Using delicate instruments the upper part of the stapes can then be removed. In order to re-establish the chain for transmission of the sound waves, a small hole is made in the remaining part of the stapes (the footplate).
A tiny piston is then inserted into the hole and attached to the second bone in the hearing chain (the incus). The vibrations from the eardrum can now be transmitted again to the inner ear. At the end of the operation, a thin ribbon-like pack is placed in the ear canal and left for two weeks.
It is quite common to feel a little dizzy after the operation. Dizziness is usually elicited by rapid head movements and so it is advisable to rest and avoid strenuous activity. It is also worth avoiding anything that might increase pressure in the head like straining or heavy lifting. If you need to sneeze try to do so through your mouth to minimize the pressure effect on the ear. It is customary to stay off work for a couple of weeks although this will depend upon the nature of your work. During this time the hearing is likely to be muffled due to the packing in the ear. After two weeks the packing is removed from the ear. However, it usually takes several weeks for the hearing to settle completely and there are often fluctuations in hearing over the first few weeks.
In general, the operation is very successful with over 90% of people experiencing a good improvement in hearing. Sometimes the hearing remains unchanged and there is a small (approx 1-2%) chance of hearing loss. Dizziness, which is experienced by most patients for a short time after the operation, may persist and become troublesome but again this is a rare complication. The nerve that supplies the taste buds at the front of the tongue can be damaged. Usually, this is only temporary but occasionally the nerve will have to be cut and a permanent loss results. The nerve that moves the face is located very near to where the surgery is taking place but it is extremely rare for this to be damaged. Sometimes the nerve may be abnormally sited and this may mean that it is not possible to complete the operation.