Stapedectomy Surgery in Singapore

• Adults with a confirmed otosclerosis diagnosis through hearing tests and clinical examination
• Patients experiencing progressive conductive hearing loss affecting daily activities
• Individuals with an air-bone gap on audiometry testing
• Those with good inner ear function (cochlear reserve) confirmed by bone conduction testing
• Patients who have tried hearing aids but prefer surgical correction
• Individuals with realistic expectations about surgical outcomes
• Non-smokers or those willing to quit before surgery (smoking affects healing)
• Patients with hearing loss in one or both ears due to stapes fixation

• Active ear infection or chronic ear drainage
• Meniere’s disease or other inner ear disorders
• Only hearing ear (relative contraindication requiring careful consideration)
• Severe sensorineural hearing loss component
• Anatomical abnormalities that prevent safe surgical access
• Blood clotting disorders or inability to stop blood-thinning medications
• Pregnancy (surgery typically postponed until after delivery)
• Severe systemic illness preventing safe anaesthesia

Professional assessment by an ENT Specialist includes comprehensive audiometry, physical examination, and sometimes CT imaging to evaluate your ear anatomy. Your ENT specialist will review your complete medical history and discuss whether stapedectomy may offer a suitable treatment option for your specific hearing loss pattern.

Before stapedectomy surgery, you’ll undergo comprehensive audiometric testing to document your hearing levels and confirm the diagnosis. Blood tests may be conducted to assess your health status for surgery. Your ENT specialist will review medications, particularly blood thinners that may need temporary discontinuation. Arrange transportation home after surgery, as you cannot drive immediately post-procedure.

Consider stopping smoking at least two weeks before surgery to support healing. Avoid aspirin and anti-inflammatory medications for one week pre-operatively unless otherwise directed. Fast from midnight before morning surgery or as instructed for afternoon procedures. Remove jewellery, particularly earrings, and avoid makeup or hair products on surgery day.

Stapedectomy typically takes 60-90 minutes under local anaesthesia with sedation or general anaesthesia. The ENT specialist works through your ear canal using a microscope, eliminating external incisions. After elevating your eardrum, they identify the stapes and assess its condition. The incus-stapes joint is carefully separated.

Using the chosen technique, the ENT specialist removes the stapes superstructure and creates an opening in or removes the footplate. The prosthesis is measured, trimmed to the appropriate length, and positioned between the incus and the inner ear opening. A tissue graft, often fascia or vein, seals the oval window around the prosthesis. The eardrum is returned to position and secured with absorbable packing.

You’ll recover in a monitored area for 1-2 hours as anaesthesia wears off. Mild dizziness or unsteadiness may occur initially. Nurses monitor vital signs and check for any symptoms. Patients typically experience minimal pain, which can be managed with mild analgesics. Hearing may seem muffled due to packing and swelling.

Before discharge, you’ll receive detailed aftercare instructions and prescribed medications, which may include antibiotics and possibly anti-vertigo medication. Someone must drive you home and stay with you for 24 hours. Schedule your follow-up appointment, typically within one week. Report severe dizziness, sudden hearing loss, or facial weakness immediately.

Temporary dizziness may affect patients for several days to weeks after surgery. This typically improves gradually and rarely persists beyond one month. Taste disturbance on the operated side may occur due to chorda tympani nerve stretching. This metallic taste or tongue numbness usually resolves within several months. Ear fullness and popping sensations are expected during healing.

Mild tinnitus may occur temporarily or, rarely, persist long-term. Some patients may notice increased sensitivity to loud sounds initially. Minor bleeding or drainage from the ear can occur for several days. These effects are generally well-tolerated and resolve with time and proper aftercare.

Complications can occur with any surgical procedure. Complete hearing loss (dead ear) may occur in rare cases. Prosthesis displacement requiring revision surgery may affect some patients over time. Facial nerve weakness, though rare due to nerve monitoring, requires immediate attention if it occurs.

Perilymphatic fistula (inner ear fluid leak) may cause persistent dizziness and hearing fluctuation. Middle ear infection can develop despite antibiotics, requiring additional treatment. Some patients may experience persistent or worsening tinnitus. Delayed facial nerve paralysis, though rare, may occur days after surgery due to viral reactivation.

Risk minimisation involves choosing an experienced ENT specialist familiar with stapedectomy techniques. Proper patient selection, meticulous surgical technique, and appropriate prosthesis choice may reduce complication likelihood. Following post-operative instructions carefully helps prevent avoidable complications.