Stapedoplasty is effective in the event that there are signs of otosclerosis. In this disease, the bone tissue is greatly expanded as a result of the mobility of the element responsible for the transmission of sound, significantly reduced.
This leads to a worsening of the hearing first on one, and then on the second ear. Audio devices only help for a while. The very operation is a method of cardiovascular treatment of otosclerosis.
Stapedoplasty
Otosclerosis is manifested by such symptoms as:
- hearing loss,
- speech understanding problems,
- strong noise in both ears.
The operation allows you to cure the disease and get rid of the symptoms. The operation is part of a group of plastic manipulations performed on the stapes. It is performed in a hospital in a planned manner after the arrest of the development of various inflammatory processes.
Indications and recommendations
Indications for use are:
- permeability of the auditory tube,
- hearing loss complaints,
- normal pressure in the middle ear,
- no additional somatic pathologies or inflammation,
- otosclerosis of conductive appearance, not associated with sound disturbance.
After the manipulations, most patients experience significant relief, note the restoration of hearing. It is important not to let the infection get. This can lead to the development of the opposite effect and a variety of different complications.
After the diagnosis, tests for determining the level of hearing, tests can be administered with:
- adhesive average otitis,
- negative Rinne test.
Comments of doctors about stapedoplasty in our video:
Technique for conducting
There are a lot of varieties of techniques. They differ among themselves in the degree of prosthetics, the material of making the prosthesis and the amount of cut tissue.
Since the method is selected according to the indications, it is better to choose the medical institution, where several methods are used at once. This will help the doctor choose the kind that would suit you.
In recent years, the most popular:
- Piston technique using biocompatible prosthesis. The stapescope looks like a piston. Over time, it is covered with the tissues of the patient. The material for manufacturing is titanium or Teflon. This is a minimally invasive approach and a low risk of rejection.
- Technique with application of autochondria. This prosthesis is made directly from the patient's tissue. Due to this, the risk of rejection is minimal.
Procedure for operation
Preparation of
Various tests are performed before the plastic surgery:
- blood group and rhesus assay,
- OAM,
- OAK,
- fluorography,
- blood sugar test,
- Wasserman reaction,
- coagulogram.
The conclusion of the therapist is signed following the results of the study. Indications for the operation are determined by the otolaryngologist. Therefore, it is important to determine whether surgical treatment is really necessary. It may be necessary to consult other specialists.
Types of prostheses for stapedoplasty
Progress of operation
Before the onset of a person, infiltration anesthesia is found. In the work the doctor uses a microscope, which allows to achieve a significant increase in the auditory organs. Before the beginning the doctor lifts the eardrum of the patient, carries out the removal of the part of the stirrup. It is replaced by a special prosthesis. The operation itself takes about an hour.
The prosthesis is worn on the long process of the anvil, the leg is inserted into the hole on the moving plate of the degree. When forming a hole, a reaction may appear from the side of the auditory or vestibular nerve. This leads to a feeling of ringing in the ears, the appearance of dizziness, which is sometimes accompanied by nausea.
In the process of ongoing manipulation, discomfort may appear, but many note the absence of any unpleasant sensations. After the operation, the hearing is checked, a tampon is inserted into it. About a day the patient should lie on that ear that has not been touched.
Demonstration video of the operation process:
Recovery and rehabilitation
The tampon from the ear is removed after a week. Through this same time the patient is discharged home. As long as the tampon is installed, it will seem as though the hearing has not improved. But this assumption is erroneous. The difference will be evident after removing the tampon. In most cases, hearing is fully restored within 90 days.
During the rehabilitation period it is necessary to avoid:
- excess overvoltage,
- lifting weights,
- strong physical exertion.
About 2-3 weeks are not allowed to fly by plane. Even more time will have to protect the ear from water ingress. Swimming can be done in a month, but scuba diving is still prohibited.
Dangerous symptoms that need to be addressed
All complications after the manipulations are divided into two types:
- short-term,
- long-term.
The first arise after the procedure, go through a few days. It can be nausea, dizziness, noise in the ears. Long-term arise after a few weeks or months. Their appearance may indicate that a repeat operation is required.
Sometimes, during surgery, the tympanic membrane is injured. Her breakthrough usually by itself passes with time. Pay attention, if you found such signs as facial paresis, acute otitis media.
Possible complications of
Among the complications can be:
- Detachment of the prosthesis from the bone. In this case, a fistula is formed in the oval window.
- The appearance of necrosis. The temperature rises, the condition becomes unsatisfactory. The cause may be rejection of the prosthesis or an immune reaction. In any case, immediate hospitalization is indicated.
- Infection of the blood. The patient becomes very ill, fever, appetite disappears, body temperature is almost impossible to knock down.
- Scar formation. The first dangerous sign of this is ear loss, traumatic pain or congestion.
- Appearance of decubitus in the place of attachment of the prosthesis. Appearance of pain and discomfort. Sometimes it becomes the cause of infection.
In extreme cases, develops an earworm, which is associated with damage to the hard shell of the brain.
What complications can occur after stapedoplasty, see in our video:
Forecast
Adverse reactions after stapedoplasty are noted only in 1% of cases. After surgery, most patients immediately notice improvement in hearing. This is confirmed by various methods of investigation.
Contraindications
Do not manipulate with:
- unilateral or progressive otosclerosis,
- external average otitis media,
- respiratory diseases,
- infections in the body.
No manipulation is carried out for bleeding and various oncological pathologies.
Diagnostic value of
The end result is influenced by various factors, for example, the type of otosclerosis, the degree of damaged structures, the conditions of restoration and healing of tissues. Since stapedoplasty occurs with the use of intra-access and using a microscope, it becomes possible to immediately see problems with the tympanic membrane and other parts of the ear, if any.