Stapes Surgery (Stapedotomy)

At your initial consultation, your ENT surgeon will take a full medical history, assess your hearing tests, and may perform a microscopic examination of the ear. This confirms that otosclerosis is the cause of your hearing loss and that stapes surgery is the most suitable option for you. 

Your procedure will take place in our dedicated Surgery Centre. When you arrive, you’ll be shown to your private patient pod, where you can change into a gown before being taken to the operating suite.

Stapes surgery is usually performed under local anaesthetic, which allows you to remain awake and comfortable while the surgeon monitors your hearing response during the procedure. Some patients may prefer a general anaesthetic, and your consultant will discuss both options with you. The surgery is typically performed through the ear canal with no external incisions, although a small incision at the top of the canal may be necessary in some cases.

During the procedure, your surgeon will use an operating microscope to see inside the ear canal. They’ll gently lift the eardrum to reach the middle ear bones. A small amount of bone may need to be removed to give a clear view of the stapes. Your surgeon will assess the stiffness of the stapes and confirm the otosclerosis diagnosis. 

The fixed upper part of the stapes is then carefully removed, usually using fine instruments or a precision laser. A tiny opening is made in the footplate (the base of the stapes), and a micro-piston prosthesis is inserted into the opening. The top of the prosthesis is then attached to the incus, the next hearing bone in the chain.

To protect the inner ear, a small piece of tissue, such as a vein or fascia, may be used to seal around the prosthesis. The eardrum is placed back into position, and if the operation is being carried out under local anaesthetic, your surgeon will perform a hearing check. 

Once the procedure is complete, a soft ribbon-like dressing is inserted into the ear canal to support healing. This dressing remains in place for about 2 weeks.

The procedure usually takes around 45 to 90 minutes, depending on the anatomy of your ear. After the procedure, you’ll return to your private patient pod to recover, supported by our dedicated nursing team. You’ll be able to go home the same day and will be given detailed aftercare advice to manage your recovery at home.

Stapes surgery is highly successful, and more than 90% of patients experience a significant improvement in hearing. However, as with any ear operation, there are risks, and your surgeon will explain these clearly.

Possible risks include:

• no improvement in hearing 

• hearing loss, which occurs in approximately 1% to 2% of cases

• dizziness, which is usually temporary but may occasionally persist

• taste changes caused by irritation of the nearby taste nerve

• injury to the facial nerve, which lies close to the surgical area (this is rare)

• ringing in the ear (tinnitus), which may improve or stay the same

• perforation of the eardrum

If hearing does not improve as expected, further surgery may be recommended.

Your consultant will guide you through preparation steps, which may include:

• avoiding heavy meals before surgery if a local anaesthetic is used 

• fasting for several hours before surgery if you’re to receive a general anaesthetic

• stopping blood-thinning medicines

• arranging time off work, especially if your job requires heavy lifting

• organising for someone to take you home, as you can’t drive for 24 hours after a general anaesthetic

• avoiding flying immediately before and after the procedure

You should also avoid colds, flu, or ear infections as much as possible in the weeks leading up to the surgery and contact your surgeon if symptoms develop.

It’s common to feel slightly dizzy after surgery, especially after standing up or moving quickly. This usually improves over the first few days. Resting with your head elevated and avoiding sudden movements can help.

You should avoid heavy lifting, straining, or bending for at least 2 weeks, as these activities increase pressure in the ear. If you need to sneeze, try to do so with your mouth open to reduce pressure on the ear.

Your hearing on the treated side will be muffled while the dressing remains in place. The packing is normally removed after around 2 weeks, and many patients notice an immediate improvement in hearing. However, full hearing recovery can take several weeks, and fluctuations during the early healing period are normal.

You should avoid flying, swimming, or getting water in the treated ear until your surgeon confirms it’s safe. Most people return to work after 1 to 2 weeks, depending on their role and how they feel.

Your consultant will arrange follow-up appointments to remove any packing, check the prosthesis position, and monitor your hearing recovery with audiology tests.

Please contact our Ear, Nose & Throat centre for pricing information.

At Welbeck, our ENT surgeons are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

To book stapes surgery, you must be referred by either your GP or an ENT specialist following a consultation with them. Self-referrals are not accepted for this treatment.

If you would like to schedule a consultation with a Welbeck ENT specialist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.