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Otosclerosis, usually an hereditary disorder, causes abnormal bone to be formed around the stapes footplate, preventing its normal movement.
Conductive deafness then results. More rarely, the bone of the cochlea is affected and results in sensorineural deafness.
Stapedectomy is an elegant solution to the problem.
The middle ear is exposed, the stapes superstructure is removed and the footplate perforated. A prosthesis of stainless steel or Teflon in place of the stapes is attached to the long process of the incus with its distal end in the oval window. The patient is usually discharged the following day and should refrain from strenuous activity for at least a month.
Stapedectomy may result in total loss of hearing in the operated ear, and patients should be made aware of such risk before operation.
Hearing aids and lip-reading
Modern hearing aids are of great benefit to patients with conductive deafness and have the advantage of causing no risk to the patient’s hearing. A hearing aid should always be offered to a patient as an alternative to surgery.
If the disease is progressing rapidly and profound deafness seems likely, instruction in lip-reading should never