Dear Doctor,
I have been diagnosed with otosclerosis of the right ear. A stapedectomy has been suggested, or a hearing aid. I am a 40 year old man.
The risks seem small, but they can be awfully disturbing. Is a laser an absolute necessity when doing this procedure? One doctor says he will use one, and the other says he does not use it?
I also have a constant tinnitus in the ear that is driving me mad! What are the real odds of losing the tinnitus with this surgery? I have heard 50/50, 30/50, etc.
What if I do not have the surgery. Am I taking a chance of the disease invading the cochlea? I have heard that often it comes back even after the surgery?
Please advise.
Thank You
Reply: ---------------------------------------
I have previously posted information which will answer some of your questions under the title "lasers in stapedectomy". You may access this under "review" prior consultations.
In experienced surgeons' hands, stapedectomy is generally safe and highly effective for carefully selected individuals with significant conductive hearing loss due to the condition known as otosclerosis. It will not correct the neurosensory ("nerve") portion of the hearing loss which may also be present in otosclerosis. One should primarily entertain the possibility of surgery to improve hearing rather than to relieve tinnitus. However, it is possible to reduce tinnitus by improving the hearing in some, but certainly not all, patients.
A successful stapedectomy may result in many years of improved and perhaps even relatively normal hearing. However, it will not significantly alter the progression of the condition of otosclerosis. Even with successful resolution of the conductive impairment to hearing, eventually neurosensory ("nerve") hearing loss develops and may result in need for hearing aids. On the other hand, the surgery is also not associated with any risk of speeding up the progression of the condition.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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