hearing loss surgery | The New York Otolaryngology Group

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Could the Malleus Prosthesis procedure be done in the U.S?

Question

I had chosteatoma when I was little, and they had to remove all three of the bones in my ear. I recently had surgery when they put in a TORP to try to regain hearing, but it was unsuccessful because there was too much scar tissue on the stapes footplate.

They then told me there was nothing else they could do to free the stapes because there was no malleus or incus they could connect it to.

Hearing Restoration SurgeryI recently read a study done by Dr. Neil Sperling where a malleus prosthesis was inserted into the external auditory canal. The TORP was then connected from the prosthesis to the footplate and the results from the study were good.

Is it possible that I could have this procedure here in the U.S?

 

Answer

Thank you for your inquiry.  The clinical situation you describe can be very difficult to repair. A laser dissection can usually correct the scar tissue associated with the stapes footplate, but without a malleus bone, it is difficult (but not impossible) to stabilize a prosthesis.

A very promising solution is the Malleus Replacement Prosthesis (MRP) developed by surgeons in France, who I worked with to report their results.

Unfortunately, this device is not yet FDA approved in this country. I have made a recent inquiry to the company who manufactures it for an estimated release date in the US, but this information is unpredictable due to the FDA’s process.

If I could be helpful to you to further consider your options, I would be happy to do so.

Neil M. Sperling, MD

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Is it still possible to get a stapedotomy, and what are the pros and cons of such a procedure?

Question:

Hi,
I am 51 years old with hereditary otosclerosis, diagnosed right after the birth  of my 1st son when I was 36. In 2009, scared by the surgery (even though successful for my mom who had the procedure done by Dr Freich, you might know since you seem to give lectures in France) I opted for a hearing aid. It has now reached it’s full capacity and I need to buy a new one. But working as a School Counselor (for the French American Pre-School), listening to kids with multicultural backgrounds is a BIG challenge! And I think I still compensate with lip reading. Is it still possible to get a stapedotomy? Do you speak some French so I could consult you and understand better the pros and cons of such a procedure?

Thank you so much for your opinion/advice.

Answer:

Hi Floriane,
I would highly recommend a consultation with an experienced stapes surgeon to discuss the pros and cons.  In experienced hands, the surgery is highly successful with a recognized complication rate less than 1%.  In France, the Clinque Causse near Beziers is a world class facility with some of the most experienced surgeons in the world.

Best of luck.

Neil Sperling, MD
New York Otolaryngology Group
36A East 36th Street
New York, New York

Associate Professor, Dept of Otolaryngology
SUNY Downstate
Brooklyn, New York

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I’m loosing my hearing again after a Stapedectomy. Is there anything new that can help me?

Question:

Hello,

I had successful bilateral stapedectomy (right ear in 1995, left ear 1996) with hearing in the normal range post op.  I started losing my hearing in my right ear again after I had my son in 2001 and 2 attempts at revision, the latest in 2004.  My revision surgeon in Albany NY stated that my incus bone was cracked which is why the prosthesis is not staying put.  I do not want to get surgery again in Albany, and am looking for the top surgeon in this field as my hearing is at 90 decibels and my ear has been ringing loudly 24/7 for at least 10 years.  Is there anything new that can help me?

Answer:

Thank you for your inquiry.  It sounds like you’ve been through quite a bit with your ear.  At your level of hearing loss, there may not be simple options.  Are you getting any benefit from traditional hearing aids? Considering the details you’ve provided, there are some cases that can be remedied surgically, using the Malleus bone instead of the Incus.  Of course, I can’t be certain that your condition would allow for this without further information, but it may be worth considering.

The next step would be careful analysis of your current audiometry, the prior surgical reports, and a detailed CT scan.

I would be happy to assist you, if you like.

best of luck and thanks for your question

Neil Sperling, MD

Associate Professor, Dept of Otolaryngology
SUNY Downstate
Brooklyn, New York

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Is there any treatment for tympanosclerosis other than surgery?

Question:

Hello,
Is there any treatment for Tympanosclerosis other than surgery? Is there any new and recent techniques for Tympanoplasty (like laser or other) that are more practical and easier? What about success rates and possibilities of hearing loss restoration? And what about potential approximate costs for such surgery?
Thank you in advance.

Answer:

Tympanosclerosis is an invasive form of scar tissue that follows infection(s) in the ear.  At times it can cause significant hearing loss.  Although not universal, many cases can be repaired surgically and hearing restored using modern Tympanoplasty techniques possibly with the use of a laser.

If you would like further evaluation and consideration of your case, please come in for an evaluation.
Best of luck!

Neil Sperling, MD

Associate Professor, Dept of Otolaryngology
SUNY Downstate
Brooklyn, New York

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Do I need revision stapes surgery?

Question:

Many years ago I was diagnosed at Mass Eye and Ear with otosclerosis. I was operated on by Dr. Joseph Nadol. Over the past few years, my hearing has once again diminished and I wonder if its possible to do a revision? Also, my other ear was never been operated on. I am 68 years old, female, and a medical librarian, and my loss of hearing is obviously impinging on my work and life. I would prefer to not have to travel back to Boston…is this something you can help me with?

Answer:

Thank you for your inquiry regarding your hearing loss. It is often possible to regain excellent hearing with revision stapes surgery. It all depends on the nature of the hearing loss that you have. The first step would be to re-test your hearing. I would be happy to help you if you’d like. You can make an appointment online or by calling our office. Best of luck.

Neil M Sperling, MD

Associate Professor
SUNY Downstate
Brooklyn, NY

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

How soon can I return to work after my ear surgery?

Question:

My primary doctor just diagnosed me with Cholesteatoma. I already have significant hearing loss and he saw skin with mucosa. I am more worried about how soon I can return to work post surgery, rather than the surgery itself.

Answer:

Cholesteatoma is common condition of the ear, but must be treated to avoid future complications. Depending on the extent of the surgery, return to work can range from 1-2 weeks. Some people who are motivated and do not have a  physically demanding job can return sooner.

I hope that is helpful, and good luck!

Neil Sperling, MD

Associate Professor, Dept of Otolaryngology
SUNY Downstate
Brooklyn, New York

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