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

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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.

Dr Marc D’Aprile, Sc.D.

Dr Marc D’Aprile is a NY State licensed audiologist at the New York Otolaryngology Group with two locations in NYC and one location in Staten Island.

Dr Marc D'AprileDirector of Audiology

Dr Marc D’Aprile, Sc.D. received a scientific doctorate in audiology from Seton Hall University in 2004. He completed his audiology residency at the Manhattan, Brooklyn and St.Albans veterans hospitals. Dr.D’Aprile then went on to work at a major hearing aid manufacturer, where he furthered his knowledge in audiology and advanced hearing aid technology. More recently, Dr. D’Aprile served as Assistant Professor of Audiology at Columbia University.

He is a fellow of the American Speech-language-Hearing Association (ASHA), a current holder of a Certificate of Clinical Competence in audiology (CCC-A), a NY state licensed Audiologist, and hearing aid dispenser.Dr. D’Aprile’s main areas of interest and expertise lie in the fitting and dispensing of state-of-the-art hearing aids, tinnitus management and custom hearing protection. His knowledge base has been maintained through regular attendance in continuing education seminars, national and state conventions, and through the direction of scholarly literature.

Dr Marc D’Aprile is committed to the success of each patient, which is achieved through the most up-to-date evidence based care. In addition, each of Dr. D’Aprile’s patients are provided custom aural rehabilitation plans which further their understanding of hearing loss and better helps in the acceptance of amplification devices.

Learn more About Dr. Neil Sperling, NYOG Audiologist

Learn more about Dr. Scott Yerdon, NYOG Audiologist

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 normal to have severe vertigo after surgery?

Question: Is it normal to have severe vertigo after middle ear surgery? I recently had a tympanotomy & stapedectomy, and now I am experiencing the symptoms of vertigo. If this is the case, how long does it usually last?
Thank you
Answer:
Thank you for your inquiry. Even though it can occur, it is not normal to have severe vertigo after having middle ear surgery. Some degree of lightheadedness and unsteadiness is common after surgery. But when it comes to any kind of surgical procedure, there are possible risks and complications that can occur.
When the symptoms of vertigo do occur it may reflect irritation of the inner ear. Careful treatment can help prevent a poor hearing outcome. In many instances, treatment includes rest, eating a well-balanced diet, and practicing the avoidance of loud noise. While a stapedectomy typically restores partial or total hearing in almost 95% of cases, for that 5% that fails, revision surgery may be necessary to solve the problem. In the case of experiencing severe vertigo after a stapedectomy, exploration of the middle ear should always be performed by a hearing specialist.
In some instances, experiencing vertigo after middle ear surgery could be related to a perilymphatic fistula. When a perilymph fistula is present, there is an abnormal opening (usually a tear or some type of defect) between the inner and the middle ear. When there is a tear present, it causes fluid to leak into the middle ear. Treatment for a perilymph fistula often requires strict bed rest, which will allow your body to repair the tear on its own. However, if symptoms do not improve your doctor may suggest surgical repair of the perilymph fistula. Going the surgical route can help prevent your symptoms from getting worse.
Seeing an audiologist regarding your symptoms is highly recommended.
Neil Sperling
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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