ENT SURGERY
Stapedectomy
Otosclerosis is one of the most common causes of progressive hearing loss in young adults. It causes a tiny bone in your middle ear — the stapes — to fuse with surrounding bone and stop moving. When the stapes cannot vibrate, sound cannot reach your inner ear. The result is a worsening conductive hearing loss that progresses silently over years.
Stapedectomy corrects this. The fixed stapes is removed and replaced with a small prosthesis that restores sound transmission immediately and permanently. Stapedectomy is successful in more than 90% of cases. The hearing gain is usually permanent. At Royal Eye & Ear Hospital, our ENT specialist performs stapes surgery with the microsurgical precision this highly delicate procedure demands.
How It Works
Stapedectomy involves these precise steps:
- 1.Anesthesia — General anesthesia. You are completely asleep throughout.
- 2.Ear canal access — The surgeon enters through the ear canal under operating microscope magnification. The eardrum is lifted to expose the middle ear. No external cuts are made.
- 3.Middle ear assessment — The ossicular chain is inspected. Stapes fixation is confirmed. The facial nerve and chorda tympani are carefully identified.
- 4.Stapes removal — The stapes superstructure is removed. For stapedotomy, a small precise fenestration is made in the footplate using a laser or micro-drill.
- 5.Prosthesis placement — A titanium piston is hooked onto the incus and inserted into the oval window. It bypasses the fixed stapes and transmits sound directly to the inner ear fluid.
- 6.Closure — The eardrum is replaced. Absorbable packing is placed in the ear canal. The procedure is complete.
The operation takes 60-90 minutes and is performed as a day procedure in most cases.
Why Choose Royal Eye & Ear Hospital for Stapedectomy?
Not all treatments are the same. The skill of your surgeon, the quality of the lens, and the care you receive after surgery all determine your outcome.
- 🏥 Dedicated Eye & Ear Specialists- We are a specialist eye and ear hospital. Ear microsurgery is a core part of our ENT programme.
- 👁️ Experienced ENT Microsurgeon-Our ENT surgical team is specialist-trained and internationally experienced. Every ear procedure at Royal Eye & Ear Hospital is performed with the precision, discipline and anatomical knowledge that microsurgery demands.
- 📍 Conveniently Located in Nairobi Based on 3rd Parklands Avenue, we serve patients from Westlands, Parklands, Gigiri, Muthaiga, and across the greater Nairobi region.
- 💊 Operating Microscope Precision- All stapes surgery is performed under operating microscope magnification.
- 🔬 Laser-Assisted Technique Available- When appropriate, we use a laser instead of a mechanical drill. This creates a highly precise opening with much less trauma to your inner ear.
Benefits of Stapedectomy
Dramatic, Permanent Hearing Relief
A stapedectomy restores hearing in over 90% of cases, usually permanently. Most patients experience a massive 30 dB boost, transforming daily speech and communication.
Freedom from Hearing Aids
Most patients no longer need hearing aids after successful surgery. For young working adults with otosclerosis, this is one of the most life-changing outcomes of the procedure.
Rapid Return of Hearing
Hearing begins to return within one week of surgery. The full benefit is typically established by 6-12 weeks — remarkably fast for a permanent surgical correction.
Improves Tinnitus
Many otosclerosis patients also have tinnitus. Surgery improves tinnitus in a significant proportion — particularly in younger patients.
Reduces Dizziness and Vertigo
Stapedectomy can improve balance and reduce dizziness linked to otosclerosis — providing benefits beyond hearing improvement alone.
Both Ears Can Be Treated
If both ears are affected, both can ultimately be operated on — one at a time, with the worse ear first.
What to Expect After Stapedectomy
Timeline:
Day 1-3
The ear feels completely blocked. Hearing in the operated ear is reduced. Mild dizziness is common. This is all normal — the inner ear needs time to settle. Rest at home, keep the ear dry, take all prescribed medications.
Days 3-7
Dizziness gradually settles. The ear remains blocked due to packing. Attend your first post-operative appointment. Hearing typically begins to return around one week after surgery.
Weeks 1-4
Hearing improves as packing absorbs and the prosthesis settles. Most patients return to desk-based work within one week. Keep the ear dry. Continue all prescribed drops.
Weeks 4-12
Hearing stabilises and the full benefit becomes clear. Formal audiometry at 6-12 weeks confirms the result. Patients may fly three weeks after surgery.
Long-term
The prosthesis is permanent and rarely fails. The hearing gain is maintained for life in the vast majority of patients. MRI is safe at any point after surgery.
Recovery Do's and Dont's:
Do’s:
✅ Rest completely for the first week
✅ Keep the ear completely dry at all times
✅ Use all prescribed ear drops and pain relief as directed
✅ Sneeze with your mouth open — never hold a sneeze
✅ Attend every post-operative appointment
✅ Report sudden complete hearing loss or facial weakness immediately
Don’ts:
❌ Do not blow your nose for at least two weeks
❌ Do not allow water into the ear canal
❌ Do not fly for at least three weeks after surgery
❌ Do not do strenuous exercise or heavy lifting for two weeks
❌ Do not insert anything into the ear canal
❌ Do not participate in contact sports for at least four weeks
RESULTS
What Results Can You Expect?
1
Outstanding Hearing Improvement
Stapedectomy restores hearing in more than 90% of cases. At low frequencies, the average improvement is around 30 dB — transforming speech clarity and daily communication.
2
Permanent Gain
The hearing gain is rapid and permanent. The prosthesis rarely fails. Once established, the improvement is maintained for life.
3
Freedom from Hearing Aids
The majority of patients no longer need hearing aids in the treated ear after successful surgery.
4
Rapid Recovery of Hearing
Hearing starts returning within one week. Full benefit is typically clear by 6-12 weeks.
Risks & Considerations of Stapedectomy⚠️
Like all surgical procedures, Stapedectomy carries a small risk of complications. At Royal Eye & Ear Hospital, our surgeons take every precaution to minimise these risks — and serious complications are rare.
1
Dizziness and Vertigo
Mild to moderate dizziness is expected in the first few days after surgery. It usually resolves quickly. Prolonged severe vertigo is uncommon.
2
Tinnitus
In the majority of patients, tinnitus improves after surgery. In a minority, it may persist or worsen.
3
Change in Taste
A metallic or altered taste sensation on the side of the tongue can occur. This is caused by proximity to the chorda tympani nerve. It typically resolves within a few months.
Patient outcome note: Your surgeon will discuss all risks clearly before surgery. The decision to proceed should be made after fully understanding both the high likelihood of significant hearing improvement and the small but irreversible risk of inner ear damage.
Frequently Asked Questions About Stapedectomy
Otosclerosis is a progressive condition where abnormal bone growth fuses the stapes with the surrounding bone. The stapes stops moving. Sound cannot pass to the inner ear. Hearing progressively worsens. It is hereditary, more common in women, and typically presents between ages 15 and 45.
Otosclerosis produces a specific audiometric pattern — conductive hearing loss with a Carhart notch at 2000 Hz and absent stapedial reflexes. Key signs include progressive hearing loss in a young adult, family history of hearing loss, and hearing that seems better in noisy environments. An ENT assessment and audiogram will confirm the diagnosis.
No. Performed under general anaesthesia. Mild dizziness and a blocked feeling are the main post-operative symptoms rather than significant pain. Paracetamol manages discomfort effectively.
Stapedectomy removes the entire stapes before inserting the prosthesis. Stapedotomy makes a small hole in the stapes footplate and inserts the prosthesis through it, leaving the rest of the footplate in place. Stapedotomy is the modern preferred technique — less traumatic to the inner ear with equivalent hearing outcomes.
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