Stapedectomy and Stapedotomy

Stapedectomy treats otosclerosis, a condition in which abnormal bone growth fixes the stapes, the smallest hearing bone, so that it can no longer pass vibrations to the inner ear. The fixed part of the stapes is replaced with a tiny piston prosthesis. Today most surgeons perform a stapedotomy, which makes a small hole in the stapes footplate instead of removing it.

In suitable ears it closes most of the conductive hearing gap in roughly nine out of ten operations. It cannot repair any inner ear component of the loss, and there is a small risk, around 1 percent, of losing the hearing in that ear.

What Stapedectomy and Stapedotomy involves

The operation is performed down the ear canal under local anaesthetic with sedation or under general anaesthetic. The eardrum is folded forward and a sliver of bone is removed from the canal wall to view the stapes. The surgeon confirms that it is fixed, separates its joint with the incus, divides its tendon and removes the arch of the bone. A 0.6 to 0.8 mm hole is made in the footplate with a laser or micro-drill. A piston of titanium or Teflon, about 4.5 mm long, is placed into the hole and crimped onto the incus, and the opening is sealed with a little tissue or blood. The eardrum is returned and the canal lightly packed.

Who is a good candidate for Stapedectomy and Stapedotomy?

Good candidates have a clear conductive hearing loss from otosclerosis and healthy eardrums.

• Conductive hearing loss with an air-bone gap of about 25 to 30 dB or more and good speech discrimination
• A normal eardrum and absent stapedial reflexes consistent with otosclerosis
• The poorer hearing ear, which is always operated first
• People who prefer surgery to a hearing aid and accept the small risk

It is usually not the right choice if:

• The only hearing ear
• Active ear infection or a perforated eardrum
• Meniere's disease or significant balance disorder in that ear
• People whose work depends on balance or pressure change, such as divers, scaffolders and some aircrew, who need individual advice
• Anyone who is content with a hearing aid, which is a safe alternative

Technique options

• Stapedotomy with laser: A laser makes the footplate hole with minimal vibration to the inner ear. The most common technique.
• Stapedotomy with micro-drill: An alternative with similar results in experienced hands.
• Total or partial stapedectomy: Removes the footplate and covers the window with a tissue graft. Used when the footplate fractures or is very thick.
• Endoscopic stapes surgery: Performed through the canal with an endoscope, often without removing canal bone.

What happens during your treatment

Surgery takes 45 to 90 minutes. Under local anaesthetic you may notice hearing improve on the table when the piston is placed. Momentary dizziness is common at that moment. Most people go home the same day or next morning with packing in the ear.

Preparing for your trip

Plan for 2 to 3 weeks because of flying restrictions in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Rest for the first few days and move slowly, as unsteadiness is common for a few days. Do not blow your nose, strain, lift heavy weights or bend sharply for 3 weeks. Keep water out of the ear. Packing is removed at 1 to 2 weeks, and hearing improves as the ear clears, with a formal test at 6 weeks. Most surgeons ask you not to fly for 2 to 3 weeks, so plan your stay or return journey accordingly. Sounds may seem harsh at first. Scuba diving is often discouraged permanently.

• Back to everyday activity: 1 to 2 weeks
• When results show: Hearing improves over 2 to 6 weeks
• How long they last: Usually decades; a minority need revision

Safety, risks and revision policy

The inner ear is opened in this operation, which explains its particular risks.

• Severe or total permanent hearing loss in the operated ear, in about 1 percent
• Dizziness, usually brief but occasionally prolonged
• Taste change on the side of the tongue, often temporary, because the taste nerve crosses the field
• New or louder tinnitus, although existing tinnitus often improves
• Eardrum perforation
• Facial nerve weakness, which is rare
• Piston displacement or erosion of the incus years later, needing revision

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Stapedectomy and Stapedotomy in Türkiye

Clinic-Y does not publish a single price for Stapedectomy and Stapedotomy, because the honest figure depends on your case. What moves it:

• Laser use and prosthesis type
• Local with sedation versus general anaesthetic
• Audiology and CT before surgery
• Length of stay needed before flying
• Revision rather than primary surgery

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions