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Ear Surgeries commonly done at the



Tympanoplasty is done to repair a hole in the ear drum/tympanic membrane. This surgery is done under general anesthesia on an outpatient basis. An incision is made behind the ear and the ear is reflected forward. The edges of the perforation are removed, the middle ear is padded with absorbable material and a graft is taken from the covering of the chewing muscle, (temporalis). The graft is placed under the ear drum remnant and the incision is closed with absorbable sutures. A dressing is placed. The operation takes one hour. The success rate (closure of the perforation) is 90%.

Ossiculoplasty is repair of the small ear bones of the middle ear for conductive hearing loss. This is usually done under general anesthesia. The ear drum is reflected forward and the ear bones are inspected. Repair is done either with repositioning the existing bones or with a plastic prosthesis. The success rate (improved hearing) is 50-90% depending on which ear bones are effected.

Stapedectomy is done for the conductive hearing loss of otosclerosis [calcium around the third small ear bone (stirrup)]. The operation is usually done under general anesthesia, but can be done under local. The ear drum is reflected forward and the stirrup is removed with the argon laser. A small metal piston is used to replace the stirrup. The success rate (improved hearing) is 98%.

Cochlear Implant is done for profound hearing loss in both ears not helped by hearing aids. An incision is made behind the ear and the implant is placed in a depression made in the skull. The electrode passes through the mastoid and middle ear into the inner ear cochlea. The operation takes two hours and is done under general anesthesia. There is a 100% success rate (improved hearing). See cochlear implant information elsewhere in this web site.

Mastoid Tympanoplasty is done for ear drum perforation with chronic infection or skin sack formation (cholesteatoma). The mastoid air cells are removed and the ear drum and ear bones are repaired. Often the ear canal has to be enlarged into the mastoid to give a safe ear that does not drain. The operation takes two to three hours and is done under general anesthesia. When the ear canal is enlarged into the mastoid (for extensive disease) the success rate (safe ear that does not drain) is over 90%.

Vestibular Nerve Section is done when the attacks of vertigo from Menieres Disease cannot be controlled with medication. An incision is made behind the ear and balance-hearing nerve is located. The balance part of the nerve is cut. The operation is done with a neurosurgeon and takes two hours. The success rate (no vertigo attacks) is over 90%. The hearing is usually not affected.

Acoustic Neuroma Removal is done from two approaches, translabyrenthine and suboccipital.

  • The translabyrenthine is done when the hearing in the affected ear is bad or when the tumor is over 1.5 cm. An incision is made behind the ear and the mastoid bone is removed. The covering of the brain is opened and the tumor is removed after the facial nerve is identified. Facial nerve monitoring is used. All hearing in the affected ear is lost with this approach. Post surgery headaches are unusual. The surgery is done with a neurosurgeon under general anesthesia. The hospital stay is usually five to six days.
  • The suboccipital approach is used if the tumor is small (less than 1.5 cm) and there is useful hearing in the affected ear. An incision is made behind the mastoid bone and a piece of skull is removed. The brain is retracted and the tumor removed after identification of the facial nerve. Facial nerve monitoring is used. Our success rate with saving hearing is 43%. The surgery is done with a neurosurgeon under general anesthesia and the hospital stay is five to six days.

Atresia Repair Occasionally the ear canal will not develop or will close (from infection). An incision is made behind the ear and a new ear canal is drilled through the mastoid bone. An ear drum is made with a graft from the chewing muscle (temporalis) and a skin graft is used to line the new ear canal so it will not stenosis. The skin graft is usually taken from the inside of the upper arm. A new opening is made in the outer ear and the skin graft is sewn to this opening. The operation takes four hours and is done under general anesthesia. An overnight stay (23 hour short stay) is required.

Intratympanic Gentamicin is done when attacks of vertigo from Meniere's Disease cannot be controlled with medication. Gentamicin is an antibiotic that suppresses the balance nerve endings. A drop of anesthetic is placed on the ear drum for anesthesia. A small incision is made in the ear drum and a needle is then inserted through the incision and Gentamicin is placed in the middle ear for 45 minutes. This is usually not uncomfortable. There are no immediate effects from the treatment but unsteadiness is usually noted about 4 days after the treatment. A second treatment is done one week later. The hearing and nystagmus are monitored before each treatment. 

Vertigo attacks are eliminated in 80%-90% of Meniere's patients. Fifty percent will have no more attacks of vertigo and 50% will need treatment in 6-24 months. Hearing is made worse in the treated ear in 5% of patients. Up to 30% of patients will notice decrease in pressure and tinnitus and improvement in hearing in the treated ear. The treatment is done in the office. 


Dr. Steenerson | Vestibular Rehab | Cochlear Implants | Tinnitus | Hearing Aids | Neuromuscular Facial Re-Ed | Download Forms | Office | Contact Us

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