Type of Surgery
Information
Last updated: 11/24/2009
Diagnosis
Diagnosis of otosclerosis is based on a combination of the patient's family history, the patient's symptoms, and the results of hearing tests. Some patients notice only a gradual loss of hearing, but others experience dizziness,...
tinnitus (a sensation of buzzing, ringing, or hissing in the ears), or balance problems. The hearing tests should be administered by an ear specialist (audiologist or otologist) rather than the patient's family doctor. The examiner will need to determine whether the patient's hearing loss is conductive (caused by a lesion or disorder in the ear canal or middle ear) or sensorineural (caused by a disorder of the inner ear or the 8th cranial nerve).
Two tests that are commonly used to distinguish conductive hearing loss from sensorineural are Rinne's test and Weber's test. In Rinne's test, the examiner holds the stem of a vibrating tuning fork first against the mastoid bone and then outside the ear canal. A person with normal hearing will hear the sound as louder when it is held near the outer ear; a person with conductive hearing loss will hear the tone as louder when the fork is touching the bone.
In Weber's test, the vibrating tuning fork is held on the midline of the forehead and the patient is asked to indicate the ear in which the sound seems louder. A person with conductive hearing loss on one side will hear the sound louder in the affected ear.
A computed tomography (CT) scan or x ray study of the head may also be done to determine whether the patient's hearing loss is conductive or sensorineural.
Preparation
Patients are asked to notify the surgeon if they develop a cold or sore throat within a week of the scheduled surgery. The procedure should be postponed in order to minimize the risk of infection being carried from the upper respiratory tract to the ear.
Some surgeons prefer to use general anesthesia when performing a stapedectomy, although an increasing number are using local anesthesia. A sedative injection is given to the patient before surgery.
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The human ear requires a number of highly specialized anatomical structures in order to transform sound wave energy into actually sounds recognized by the brain. This animation shows the various structures of the outer, middle and inner ear and how they work together to detect sound.
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Other Information
A stapedectomy is a surgical procedure of the middle ear performed to improve hearing. The world's first stapedectomy is credited to Dr. John J. Shea, Jr., performed in May, 1956, the first patient being a 54 year-old housewife who could no longer hear even with a hearing aid. In recent years, Dr. William H. Lippy, from Warren, Ohio, has been credited with a multitude of advances in the surgery including his speciality which is revision surgery.
Other Information
In 2006, estimates of the direct medical costs of allergic rhinitis in the US ranged from $1.16 billion to $4.5 billion, rising to $7.7 billion when indirect costs were included.
From: AHRQ
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