GENERAL MEASURES Hearing aids
SURGICAL MEASURES
β’ Surgical correction (stapedectomy): Usually involves mobilization or removal of the stapedial foot plate with
placement of a stapes prosthesis. Recent procedural innovations have involved use of lasers.
β’ Relative indications for surgery include: Negative Rinneβs test (air-bone audiometric gap at least 20 dB);
bilateral involvement
ACTIVITY No restrictions
DIET No special diet
PATIENT EDUCATION
β’ Because speech discrimination is usually preserved, patients should be advised of the possible benefit from
hearing aids (as an alternative or adjunct to surgery)
DRUG(S) OF CHOICE No specifi c drug therapy but sodium fluoride, vitamin D and calcium gluconate have been tried, especially in cases of predominantly sensorineural hearing loss
PATIENT MONITORING Interval audiometric testing
POSSIBLE COMPLICATIONS Surgical risks include chorda tympani nerve injury, tympanic membrane laceration, ossicular chain disruption, otitis media and externa, labyrinthitis, granuloma formation, perilymph fistulae, and total deafness (dead ear)
EXPECTED COURSE/PROGNOSIS Progressive hearing loss if not treated. Surgery improves hearing by at least 15 dB in 90% of cases.