Stapes Surgery

Following precautions are to be taken before the surgery: –

• Till the preceding night of the surgery the patient must take all medications prescribed by the ENT surgeon. The patient is advised to bring along all prescribed and non-prescribed medicines that he/she is currently taking in original packaging.
• The patient must get a good night’s sleep and should not eat anything at all from midnight onwards prior to the surgery day.
• The patient should bring the hospital file at the time of the check-in for surgery including all required test reports such as the major surgical profile, audiological evaluation reports, pre- anaesthetic check-up sheet, radiological investigation films and reports (X-ray, CT scan, MRI, PET scan etc.) and any others investigations advised by your ENT surgeon. It is advised to ready this file a day before the surgery.
• The patient must shampoo their hair before the surgery day. Male patients are advised to ensure a short haircut.
• The patient should be accompanied by an attendant. It is advised to bring along a close family member.
• The patient should report at the hospital at least three hours prior to the surgery’s scheduled timing.
• Report at the reception desk in time and the hospital staff will guide through the next steps.
• Be sure to mention it to the doctor and anaesthetist there is any as cough, cold, fever or throat pain. Mention beforehand if allergic to any drugs.

• In the first 24 hours, complete bed rest is recommended. Do not lie on the side of the operated ear.
• Food or drink is not allowed for 4-5 hours after surgery. After that water is allowed. Caffeinated beverages such as tea, coffee or aerated drinks are to be avoided. Semi-solid diet in moderate quantities is allowed after 12 hours and normal food from second day onwards.
• After discharge, all medications are to be taken as prescribed by the surgeon. If the prescription medicines cause any drug reactions such as rashes or stomach upset etc., call the doctor immediately.
• Do not oil your hair or clean your ear till it is allowed.
• Stay away from people with cough and cold.
• Do not blow nose with excessive force and while sneezing, do so with your mouth open.
• Do not have a head bath for a full one month after the surgery. No water should get into the ear. However, daily bath that does not wet or spoil your head bandage till the time it is on your head, is allowed.
• Do not sleep on the operated side for a month afterwards.
• Do not undertake strenuous work or travel by air for a month afterwards.
• Can resume regular office work/house work after 3 days of surgery (unless specially advised by the operating surgeon)
• Swimming and other water activities are allowed after 3 months of the surgery. However, high-pressure activities such as diving or deep-water swimming etc should be avoided. Surgeon’s permission is must before planning any such activity.
• Change the cotton outside the ear three times a day using the method demonstrated by the hospital staff and clean behind your ear while bathing.
• Wear cotton balls or ear plugs over the ear opening. 
• Keep an eye open for excessive ear discharge.

Post-operative follow-up visits with the operating surgeon can be scheduled as follows:

1. 10 days after surgery for dressing (1st visit)
2. Every 10 days in the first month after the initial visit (2nd & 3rd visits)

• A stapes surgery carries some risks that one should know prior to giving consent to this treatment. They are as follows: –

  • Loss of hearing: An occasional patient (1 patient in every 100 for experienced surgeons) can suffer from further hearing impairment due to damage to the inner ear. This hearing impairment can be to a severe extent (not remediable even by hearing aid) in the operated ear. Therefore, surgeons usually operate upon the poorer hearing ear first to minimize risk.
  • Dizziness: Dizziness for a few hours after the surgery is normal. In some cases, it may last longer. 
  • Taste disturbance: The taste nerve runs close to the eardrum and may sustain some damage to cause abnormal taste on one side of the tongue. While this taste disturbance is mostly a temporary phenomenon, it may be permanent in some cases (up to 1 in 10 cases).
  • Tinnitus: If the hearing loss worsens, the patient may suffer from tinnitus or noises in the ear.
  • Allergic reaction to ear dressings: Occasionally the ear may show allergy to the dressings in the ear canal leading to a red, swollen and inflamed pinna (outer ear). Consult the surgeon for dressing removal and settling down of the allergic reaction.
  • Other complications: As a stapes surgery entails some degree of risk toward total loss of hearing, along with possible disturbance of balance or taste, it could have serious implications for certain careers (like chef, musician, teacher, sportsperson, dancer etc). It is advised to discuss all the concerns with the ENT surgeon well in advance. Some ENT surgeons also advise the patient against scuba diving, sky diving or use of firearms after a stapes surgery.