Stapedectomy (otosclerosis surgery) (Stapedectomy / stapedotomy)
An operation for otosclerosis that replaces the fixed stapes (the smallest hearing bone) with a tiny prosthesis to improve a specific type of hearing loss.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It treats the conductive hearing loss of otosclerosis by replacing the fixed stapes bone with a tiny prosthesis.
- A hearing aid is a genuine alternative that avoids surgical risk — this is a personal choice, not surgery-by-default.
- Most people hear better afterwards, but there is a small risk of making hearing worse, including a rare 'dead ear'.
- It is done one ear at a time by a surgeon who does this operation regularly; taste change and dizziness are common early on.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can improve hearing in the operated ear in most suitable people
The operated ear is the only ear with useful hearing — losing it would be devastating, so surgery is usually avoided.
Expect a blocked, muffled ear and possibly some dizziness. Rest, avoid sudden head movements and take painkillers as advised. Do not get water in the ear.
A planned follow-up hearing test to confirm and record the result.
Expect a blocked, muffled ear and possibly some dizziness. Rest, avoid sudden head movements and take painkillers...
Any packing is usually removed at a clinic visit. Many people return to desk work within one to two weeks. Avoid...
Hearing often begins to improve as swelling settles. Continue to avoid swimming, diving, flying and strenuous...
A follow-up hearing test checks the result. The settled hearing outcome is usually clear by this stage.
What is a stapedectomy (otosclerosis surgery)?
Otosclerosis is a condition where abnormal bone grows around the stapes — the smallest of the three tiny bones that carry sound through the middle ear. As the stapes becomes fixed, it can no longer pass vibrations to the inner ear, causing a 'conductive' hearing loss that often gets slowly worse and frequently affects both ears.
A stapedectomy (or the more common 'stapedotomy', where only a small opening is made) removes or bypasses the fixed stapes and places a tiny prosthesis to restore sound transmission. It treats the mechanical part of the hearing loss; it does not reverse any nerve (sensorineural) hearing loss that may also be present.
It is not the only option. A well-fitted hearing aid can manage the same hearing loss without surgery, and some people choose to do nothing for now. Surgery is usually offered to one ear at a time, and the choice between surgery and a hearing aid is a personal, shared decision.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Stapedotomy
The most common modern technique. A small hole is made in the base of the fixed stapes and a piston prosthesis is placed through it. It tends to give a more controlled result...
Stapedectomy
The older approach, removing a larger part or all of the stapes footplate before placing a prosthesis. 'Stapedectomy' is still used loosely to mean the whole family of...
Laser-assisted technique
A laser is used to make the opening in the stapes precisely with minimal movement, which some surgeons prefer to reduce trauma to the inner ear.
Revision stapes surgery
A second operation if the first does not improve hearing, the prosthesis moves, or hearing later worsens. Success rates are lower and the risk to the inner ear is higher than...
Preparing for your surgery
- See the operating surgeon and have a hearing test (audiogram) that confirms a conductive hearing loss suitable for surgery.
- Discuss honestly whether a hearing aid might suit you instead, and which ear to treat if both are affected.
- Tell your surgeon about dizziness, balance problems, or hearing in only one good ear, as these change the risk balance.
- Mention all medicines and supplements, especially blood thinners, which may need managing.
- Arrange a lift home and someone to stay with you on the first night after an anaesthetic.
- Plan around one to two weeks off, and avoid flying, diving and heavy lifting in the early weeks.
- Expect to keep the ear dry while it heals.
What happens
The operation usually takes about 45 to 90 minutes and can be done under local anaesthetic with sedation or under general anaesthetic. The surgeon works through the ear canal using a microscope, lifts the eardrum, and reaches the middle-ear bones.
The fixed stapes is removed or opened, and a tiny prosthesis is placed to bridge the gap so sound can again reach the inner ear. The eardrum is then laid back into place and a small dressing or pack may be put in the ear canal.
Most people go home the same day. Hearing may sound muffled at first because of packing and swelling, and it is normal to feel a little unsteady. A small taste nerve runs across the area, so an altered or metallic taste on one side of the tongue is common for a while.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The operated ear is the only ear with useful hearing — losing it would be devastating, so surgery is usually avoided.
- The hearing loss is mainly sensorineural (nerve) rather than conductive, which surgery cannot fix.
- Active ear infection or an unhealthy eardrum that needs treating first.
- Someone who would be content with, or prefers, a hearing aid and does not want surgical risk.
Delay surgery if…
- There is a current ear or upper-airway infection.
- A confirming hearing test (audiogram) has not yet been done.
- Blood-thinning medicines need safe management before surgery.
- You have unexplained dizziness or balance symptoms that need assessment first.
- You cannot arrange a lift home, overnight support or time off.
Alternatives to discuss
- A well-fitted hearing aid, which avoids surgical risk and can be very effective.
- Watchful waiting if the hearing loss is mild and not troubling you.
- Treating the better-hearing strategy first and considering surgery later.
- A second specialist opinion, particularly before revision surgery.
- Bone-conduction hearing devices in selected cases.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can improve hearing in the operated ear in most suitable people
- May reduce or remove the need for a hearing aid in that ear
- Treats the mechanical cause directly rather than only amplifying sound
- Day-case operation with a relatively short recovery for most people
- Can be reconsidered or revised if the first operation does not work as hoped
Risks & complications
- Altered or metallic taste on one side of the tongue, and a dry-mouth feeling, for a time
- Temporary dizziness or unsteadiness in the first days
- Muffled hearing early on from packing and swelling
- Tinnitus (noises in the ear) that may be new or temporarily worse
- Hearing that does not improve as much as hoped
- A small hole in the eardrum that may need treatment
- The prosthesis not sitting perfectly, sometimes needing revision
- Infection of the ear after surgery
- Hearing that ends up worse than before
- Severe (sensorineural) hearing loss, including very rarely a 'dead ear' with total loss of hearing in that ear
- Lasting dizziness or balance disturbance
- Weakness of the face on the operated side (facial nerve), which is very rare
- A 'perilymph gusher' (sudden inner-ear fluid leak) managed during the operation
The most important risk to weigh is that a small number of people end up with worse hearing, and very rarely a total loss of hearing in the operated ear. This is why surgery is done one ear at a time and why a hearing aid is always a reasonable alternative. Tell your surgeon if the operated ear is your only good ear, and ask about their own complication rates.
Published figures to discuss
Hearing results and complication rates depend strongly on the surgeon's experience and whether it is a first or revision operation. Quoted figures come from surgical series rather than UK-wide audits, so treat them as a guide and ask your surgeon for their own results. The figures below are cautious and source-defensible.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Successful closure of the 'air–bone gap' (hearing improvement) | Around 90% in first (primary) operations, falling to roughly 70% in revision surgery (surgical series) | Success depends on patient selection and surgeon experience; nerve hearing loss is not corrected. | StatPearls — Stapes surgery for otosclerosis (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure |
| Sensorineural (nerve) hearing loss as a complication | Reported around 1–2% in primary surgery and higher (around 4%) in revision surgery; experienced units aim for under 1% serious loss | Includes the rare, devastating outcome of a total loss of hearing ('dead ear') in the operated ear. | StatPearls — Stapes surgery for otosclerosis (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure |
| Taste disturbance (chorda tympani nerve) | Common, at least temporarily; the nerve can be preserved in roughly 90% of cases | An altered or metallic taste usually improves over weeks but can occasionally last. | StatPearls — Stapes surgery for otosclerosis (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery is usually quicker than many ear operations — most people are back to light activity within one to two weeks — but the final hearing result settles over several weeks to months as swelling and packing resolve.
- A blocked, muffled ear for the first couple of weeks
- An altered or metallic taste on one side of the tongue that usually improves over weeks
- Mild dizziness or unsteadiness in the first few days
- Temporary tinnitus or popping sounds
- Gradual, rather than instant, improvement in hearing
Aftercare
- Keep the ear completely dry until your surgeon confirms it has healed.
- Avoid blowing your nose hard; sneeze with your mouth open in the early days.
- Avoid heavy lifting, straining, swimming, diving and flying until cleared.
- Take painkillers as advised and move gently if you feel dizzy.
- Use any prescribed drops exactly as directed.
- Attend your follow-up hearing test to confirm the result.
- Save the clinic's contact number in case of severe dizziness, facial weakness or sudden hearing loss.
- Lift home and an adult to stay overnight after the anaesthetic
- One to two weeks off work booked
- Painkillers and any prescribed drops collected
- Cotton wool and petroleum jelly to keep the ear dry
- Follow-up hearing-test appointment noted
- Clinic out-of-hours number saved
Scars and how they heal
Most stapes surgery is done through the ear canal, so there is usually no visible external scar. Occasionally a small cut is made just in front of or behind the ear to take a tiny piece of tissue for the repair; this is hidden in a natural crease and fades over months.
⚠ Get urgent help if…
- Sudden or worsening loss of hearing in the operated ear
- Severe or persistent dizziness, spinning or repeated vomiting
- New or worsening weakness or droop of the face on the operated side — seek help urgently
- Severe ear pain, fever or spreading redness
- Clear watery fluid leaking from the ear
- Heavy bleeding from the ear that does not settle
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the conductive part of the hearing loss is largely corrected, so everyday hearing in that ear is clearer and a hearing aid may no longer be needed there. Most suitable people gain useful improvement, and surgeons aim to close most of the 'air–bone gap' that the otosclerosis caused.
It cannot fix any nerve (sensorineural) component of the hearing loss, will not stop otosclerosis affecting the other ear, and a small number of people are no better or worse. The final result is judged on a follow-up hearing test a few weeks to months after surgery.
Many people enjoy improved hearing for years after successful surgery, but the prosthesis can occasionally slip or loosen, and otosclerosis can continue to affect the inner ear or the other ear over time. Some people eventually need revision surgery or a hearing aid later. Your surgeon will explain how your result will be monitored.
Combining with other procedures
Surgery is normally done on one ear at a time, and the second ear, if affected, is usually only considered later once the first has settled and the result is known. It is not routinely combined with other ear operations.
Follow-up & long-term care
You will usually be seen within the first couple of weeks to remove any packing and check healing, then again at around six weeks to three months for a hearing test that confirms the result. Report any sudden hearing loss, severe dizziness or facial weakness straight away rather than waiting.
- A follow-up hearing test to confirm and record the result
- Longer-term hearing checks if symptoms change
- Review of the other ear if otosclerosis is also affecting it
- Prompt review if hearing later worsens, in case the prosthesis has moved
- Considering a hearing aid if surgery does not fully correct the hearing
Revision and secondary surgery reality
- Revision surgery is offered if hearing does not improve, the prosthesis moves, or hearing later worsens.
- Success rates are lower and the risk to the inner ear is higher in revision than in the first operation.
- Some people choose a hearing aid rather than revision after weighing the risks.
- The other ear, if affected by otosclerosis, may eventually need its own treatment.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A planned follow-up hearing test to confirm and record the result.
- Clear written warning signs and a named contact for sudden hearing loss, severe dizziness or facial weakness.
- Honest discussion of the result, including hearing-aid options if surgery falls short.
- Advice on keeping the ear dry, and on when flying, diving and exercise are safe again.
- A plan for the other ear if it is also affected.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The operating surgeon's fee and whether it is a first or revision operation
- Local anaesthetic with sedation versus general anaesthetic, and the anaesthetist's fee
- Theatre and facility fees
- The prosthesis used
- Pre-operative and follow-up hearing tests
- Follow-up appointments
- Any revision surgery or hearing aid needed later
- The surgeon's fee and which ear/operation it covers
- Anaesthetist's fee and the type of anaesthetic
- Theatre and facility charges
- Cost of pre-operative and follow-up hearing tests
- Whether the prosthesis is included
- Number of follow-up appointments included
- What happens, and who pays, if hearing does not improve or revision is needed
On the NHS? Stapes surgery for suitable otosclerosis is available on the NHS, with a hearing aid as the main non-surgical alternative; private care is mainly used for speed of appointments or choice of surgeon.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being offered a hearing aid as a genuine alternative to surgery.
- Glossing over the small but real risk of worse hearing or a 'dead ear'.
- Operating on a sole hearing ear without very careful, explicit discussion.
- No written emergency instructions for sudden hearing loss, severe dizziness or facial weakness.
- Not asking about, or being given, the surgeon's own results.
Marketing red flags
- Promising guaranteed or 'perfect' hearing restoration.
- Downplaying or omitting the rare risk of total hearing loss in the ear.
- Recommending both ears be done at the same time.
- Describing the operation as quick and without risks.
- Pushing surgery without a confirming hearing test or any mention of hearing aids.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Is my hearing loss the right type for this operation, and how much improvement is realistic for me?
- How does surgery compare with simply using a hearing aid in my case?
- What are your own success and complication rates, including the risk of a worse or 'dead' ear?
- Which ear would you treat first, and why?
- How will my taste and balance be affected, and for how long?
- What would happen if the first operation does not work?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Should I have surgery or just use a hearing aid?
Could the operation make my hearing worse?
Why does my taste feel strange afterwards?
Will both ears be done at once?
Is it available on the NHS?
When can I fly again?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: StatPearls — Stapes surgery for otosclerosis (NCBI Bookshelf) StatPearls — Otosclerosis (NCBI Bookshelf) Torbay and South Devon NHS — Stapedotomy patient leaflet NHS — Hearing loss Cost-effectiveness of stapedectomy vs hearing aids — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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