Stapedectomy (Stapes Surgery) Cost and Procedure Guide

Imagine a life where everyday sounds — laughter, music, even conversations — fade into a distant murmur. Hearing is an essential part of connecting with the world around you, yet many people face challenges with their hearing every day.¹ In some cases, hearing loss may originate with the tiny bones deep in your middle ear. In particular, the STAPES (pronounced STAY PEAS) bone sometimes get fixed within the oval window which prevents it from vibrating as it normally does. This condition is often called “otosclerosis” and can often be addressed surgically via a stapedectomy, often called stapes surgery or a stapedotomy.

How the Stapes Bone Works

When you hear, sound waves make your eardrum vibrate. This sound is amplified by the three middle ear bones, the malleus, incus and stapes (also known as the hammer, anvil, and stirrup.) These bones send the amplified sound waves to the cochlea in your inner ear. If your stapes can't vibrate properly, the sound waves won't be transmitted correctly, which impairs your hearing.

What Is a Stapedectomy (Stapes Surgery)?

A stapedectomy is a surgical procedure that removes your stapes bone and replaces it with a prosthetic ear bone.  The new prosthesis conducts sound waves into your inner ear better than the original bone, improving your hearing.  While this may sound like a daunting surgery, it's actually a fairly common procedure. 

Some conditions that may damage your stapes include:

• Severe middle ear infections
• Ear bone damage from previous surgery
• Congenital abnormality
• Bone fracture
•  Tympanosclerosis
• Paget's disease

Stapedectomy (Stapes Surgery) for Otosclerosis Patients

Stapes surgery is sometimes recommended when your ear's stapes bone becomes frozen or stuck. The most common reason for this is a condition called otosclerosis. This occurs when new bone grows around your stapes and stops it from moving. About 3 million Americans have otosclerosis, which can be hereditary or be caused by stress fractures, immune disorders or previous measles infections. The good news is that a stapedectomy or stapes surgery improves hearing in about 90% of otosclerosis cases.

Stapedectomy vs. stapedotomy

Both procedures, stapedectomy and stapedotomy, implant a prosthetic stapes to improve hearing.

A stapedectomy involves removing the entire stapes footplate and replacing it with a prosthesis. A stapedotomy uses a laser or micro drill to create a small hole in the footplate. The prosthesis is put in that hole. Whichever surgery you and your surgeon choose, you'll still need sedation or general anesthesia, and it will take about the same amount of time.

Studies have found that the proficiency of the surgeon affects the outcome of your surgery more than whether you choose a stapedectomy versus a stapedotomy.

How Much Does a Stapedectomy (Stapes Surgery) Cost?

Stapes surgery can be expensive, costing thousands of dollars. The price depends, in part, on where you're having your surgery, as well as your doctor and the tools and supplies used.

One study found that the mean cost of a stapes surgery is $3,500, but the cost can range from $2,284 to $4,800 or more depending on multiple factors such as the cost of surgical supplies and whether a laser (there are many types) or microdrill is used. For example, one laser may cost $850 versus using another laser which costs $230.¹

Does Insurance Cover a Stapedectomy (Stapes Surgery)?

Most insurance plans will cover at least some of the cost of a stapedectomy if it's considered medically necessary. In fact, many surgeries that help restore hearing will be covered by health insurance. However, your final cost depends on a variety of factors, including your deductible and copay, as well as whether you are seeking services in or out of network. Check with your plan provider to determine your specific benefits.

If you have Medicare, they estimate that you would pay $734 at a surgical center and $1,297 at a hospital outpatient department.²

If you don't have the funds readily available, you might want to plan ahead by setting up a financing option before your surgery.

How Does a Stapedectomy (Stapes Surgery) Work?

Your middle ear has three bones that help with hearing: the stapes, incus and malleus. The stapes is the innermost of the three bones and the one removed during your surgery. The other two bones are left in place. The surgery takes 60-90 minutes.

Here's how it works.

Preparation

Your doctor will tell you exactly how to get ready for your surgery. Preparation will likely be simple, perhaps including the following steps:

• Stop medication that thins your blood, such as aspirin, a week before.
• Stop taking any nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen a week before.
• Don't eat or drink anything after midnight before your surgery.
• Fill your prescriptions before your surgery.

Procedure

During the procedure, the surgeon folds up your eardrum and ear canal skin, similarly to how a window shade is rolled up. This lets the surgeon evaluate your ear bones more closely to confirm your diagnosis.

The surgeon separates the stapes bone from the incus bone, often using a laser to cut through tendons so they can remove the top part of the stapes. Next, they'll remove about one-third to one-half of the stapes footplate with a laser and then add a graft over the exposed inner ear. They'll attach one end of the prosthesis to the graft and one end to the incus bone.¹

Possible side effects

Some common (and often temporary) side effects include:

• Nausea or dizziness that's mild and lasts about a day
• Sensitivity to motion that can last a few days
• Temporary taste changes that occur because a nerve involved in taste has to be moved during surgery
• High-frequency hearing loss in about 5% to 10% of cases.
• Pain or a full feeling in your ear
• A small amount of fluid or drainage from your ear
• Temporary hearing loss or muffled noises
• Hyperacusis, where you may be more sensitive to sounds, such as sudden loud noises, for about a month

More serious but rare side effects include:

• No improvement in about 1% to 2% of patients
• Worsening tinnitus
• Perforated eardrum
• Damage to other ear bones
• Facial nerve paralysis
• Total hearing loss (deafness) in about 1% of cases
• Infection
• Balance issues

Stapedectomy (Stapes Surgery) Revision Surgery

If your hearing simply doesn't improve, you may need a revision (or repeat) surgery. However, your doctor will want to wait at least a few months before making this determination, to give your inflammation time to resolve. You may need tests like a CT scan first to make sure other issues aren’t causing the problem.

In about 5% of patients, hearing loss returns, often requiring revision surgery. This usually happens two to four years after the first surgery, but it can occur sooner or later.

Conditions that might require revision surgery include:

• Prosthesis malfunction (typically due to displacement, sometimes because the prosthesis was too short or too long)
• Incus bone erosion
• Adhesions to the prosthesis or incus bone
• Bone regrowth

Recovering from a Stapedectomy (Stapes Surgery)

After your surgery, your doctor will put antibiotic ointment and surgical packing into your ear that dissolves over time. Otherwise, you'll need to return to your doctor in a week to get it removed.

After the first week, you can gradually begin returning to most normal, non-strenuous activities. However, for the first four to six weeks, you should avoid blowing your nose, lifting anything over 10 pounds, doing heavy exercises or straining. Keep water out of your ear for two to three weeks.

The good news is that recovery isn't difficult. It's rare to have serious complications, and your hearing will continue to improve for the first few months. You may even notice some hearing improvement right away.

Frequently Asked Questions About a Stapedectomy (Stapes Surgery)

Do you still have questions about a stapedectomy (stapes surgery)? Here are answers to some commonly asked questions about this procedure.

Financing a Stapedectomy With the CareCredit Credit Card

The CareCredit credit card can help you pay for hearing care, including a stapedectomy, regular hearing tests, screenings and more.* Use our Acceptance Locator to find a hearing specialist near you that accepts CareCredit. Continue to invest in your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

In addition to hearing care, you can also use your CareCredit credit card for dentistry, cosmetic, pet care, vision, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Expert Reviewer

Dr. Douglas L. Beck, Au.D.

Dr. Douglas L. Beck is among the most prolific authors in audiology with some 260 publications, interviews, and op-eds written for the AAA, Hearing Review, Audiology Online, The Hearing Journal, the Journal of Otolaryngology ENT Research and other professional publications. Dr. Beck’s new book, “The Consumer’s Guide to Hearing Care and Hearing Loss and Hearing Aids (and More) for Adults,” is available on Amazon. Dr. Beck is a sought-after lecturer globally and has presented more than 1,000 lectures, keynote addresses, webinars and other professional presentations.

Author Bio

Stephanie Dwilson specializes in science journalism, breaking news and animal health and is a business owner, non-practicing attorney and writer.