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Otosclerosis and Stapedectomy
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Otosclerosis is a condition that causes a progressive loss of hearing. It is most commonly diagnosed in middle aged white females, and there is a family history of otosclerosis in 50% of cases. The patient usually begins to notice difficulty with conversations that slowly gets worse over months or years.

Otosclerosis is caused by abnormal bone formation around the stapes (stirrup) bone, one of the tiny bones in the middle ear, which is behind the ear drum.  It causes conductive (something blocking sound from reaching the inner ear) hearing loss, as opposed to sensorineural (nerve damage/loss) hearing loss, at least early in the disorder. 

Patients with otosclerosis typically do not have a history of ear infections, and their ears usually appear completely normal on exam.  An audiogram (hearing test) is needed to distinguish otosclerosis from other forms of hearing loss.  Otosclerosis will get worse over time and many patients will eventually develop the condition in both ears.  

There are only two treatments for otosclerosis:  a hearing aid or surgery.  The surgical procedure to correct otosclerosis is called stapedectomy, and it was invented in Memphis in 1956 by Dr. John Shea, father of Dr. Paul Shea, and founder of the Shea Clinic.  This highly successful procedure changed the trajectory of modern otology, launched Dr. John Shea’s career, and made the Shea Clinic the internationally known center of excellence in otology and otolaryngology that it is today. It is performed throughout the world in much the same way as was originally described by Dr. John Shea in 1956.

Stapedectomy is an outpatient procedure performed at the Shea Clinic Ambulatory Surgery Center by Dr. Paul Shea.  It typically takes about one hour.  Under general anesthesia, Dr. Shea will lift the ear drum out of the way to inspect the stapes and other middle ear bones under a microscope.  If it is confirmed that the patient has otosclerosis, then Dr. Shea will remove the tiny stapes bone and replace it with a prosthesis (replacement bone) made of plastic.  He will seal the opening made into the inner ear when removing the stapes with a piece of vein from the patient’s hand.  He will then place the eardrum back into position.  

Most patients notice hearing improvement as soon as they wake up.  When performed correctly, stapedectomy patients are some of the happiest and most satisfied of all patients undergoing otologic (ear) surgery.  Dr. Paul Shea performs the procedure the same way his father did for over 50 years, and the success rate is over 95%.  There is no pain with the procedure, but some patients may be slightly off balance for a few days afterward.  The second ear can be operated on approximately six months after the first.  

Stapedectomy is a highly specialized and technically challenging operation and most general ENT (ear, nose, and throat) surgeons refer patients with otosclerosis to an otologist like Dr. Paul Shea, who has the additional training and experience to perform the extremely delicate procedure.  If you have been diagnosed with or believe you may have otosclerosis, please make an appointment for a consultation with Dr. Paul Shea at the Shea Clinic. 


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