Another cause of middle ear hearing loss is bony remodelling processes at the oval window, which lead to a fixation of the stapes. Patients, who are often female, complain of slowly progressive hearing loss and ringing in the affected ear.

The treatment of the disease known as otosclerosis , which leads to progressive conductive hearing loss, consists of replacing the fixed stapes with a titanium prosthesis (stapesplasty).

To do this, the eardrum is also mobilised through an ear canal incision and folded to the side. The stapes is then removed and a hole is made in the footplate. We use a laser for this in our clinic. However, electric or manual microdrills can also be used. Complete removal of the footplate is no longer performed due to unsatisfactory postoperative hearing results.

A titanium cylinder is inserted through the opening created in the stapes footplate and the protruding eyelet is attached to the anvil leg. The eardrum is then folded back and the auditory canal is tamponaded. The tamponade usually remains in the ear canal for 1-2 weeks.

This procedure can also be performed under local anaesthetic or general anaesthetic . One advantage of local anaesthesia is the immediate control of the hearing success achieved, but at our clinic we usually perform the procedure under general anaesthesia.