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Conductive Hearing Loss

Otosclerosis and Stapedectomy
Ossicular Chain Abnormalities

Otosclerosis and Stepdectomy 

There are many potential causes of conductive hearing loss. Otosclerosis is a condition in which the stapes bone becomes fixated by abnormal bone growth over time. This condition results in a conductive hearing loss that can become severe over time. Otosclerosis can usually be diagnosed with an otolaryngology examination and hearing test.
 
 
 
Figure 1  Normal hearing mechanism 
 
Treatments
The hearing can be restored with a surgical procedure called stapedectomy. Hearing aids can be helpful in patients who do not desire surgical treatment. 
 
Stapedectomy
Stapes fixation due to otosclerosis or other causes can be corrected with a surgical procedure called stapedectomy. The procedure is an outpatient surgery that takes 30 to 40 minutes. It is performed under local or general anesthesia. The surgery is performed through the ear canal. 
 
How the Surgery Works
The non-functioning stapes bone is removed and replaced with an artificial implant.
 
 
  
Figure 1  Stapes bone fixated (right ear).
 
  
Figure 2  Stapes bone replaced with implant (right ear). 
 
After Surgery Care
Antibiotic ear drops are used in the ear after surgery. Regular activities are started the next day. Patients are typically seen 3 weeks after surgery to ensure proper healing and a hearing test is performed. 
 
How Long Does the Surgical Correction Last?
The hearing implant typically lasts for the life of the patient. In a small number of cases, the implant function may decrease over time. In these cases, revision surgery can often restore the hearing again.

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Ossicular Chain Abnormalities

There are many potential causes of conductive hearing loss.  The sound conduction system in the middle ear consists of three small bones called ossicles.  These bones can be damaged by recurrent ear infections, trauma or previous surgery.  This disruption results in a conductive hearing loss that can become severe over time.  Ossicular chain abnormalities can be diagnosed with an otolaryngology examination and hearing test.


 
Figure 1 Normal hearing mechanism

What are the treatment options?

The hearing can be restored with a surgical procedure called ossicular chain reconstruction.  Hearing aids can be helpful in patients who do not desire surgical treatment.


What is Ossicular chain reconstruction?

Ossicular dysfunction can be corrected with a surgical procedure called Ossicular chain reconstruction.  The procedure is a relatively brief outpatient surgery performed under either local or general anesthesia.  The surgery is performed through the ear canal.


How does the surgery work?

The non-functioning ossicle (bone) is removed and replaced with an artificial implant.


 

Figure 2 Displaced incus bone (left ear).



Figure 3 Left middle ear implant to replace incus bone



Figure 4 Missing middle ear bone replaced with implant (right ear).


After Surgery Care

Antibiotic ear drops are used in the ear after surgery.  Regular activities are started the next day.  Patients are typically seen 1-6 weeks after surgery to ensure proper healing and a hearing test is performed.


How Long Does the Surgical Correction Last?

The hearing implant typically lasts for the life of the patient.  In a small number of cases, the implant function may decrease over time.  In these cases, revision surgery can often restore the hearing again.

By Joseph Chang, MD

For more information on Conductive Hearing Loss click here.

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