Q & A

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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.

I 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

Q & A

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

Question: 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 stapedotomy 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

Q & A

Do I have otosclerosis?

Question: Recently semi-diagnosed with otosclerosis. History of swimmers ear, right ear, and for over 3 years recurrent ear infections, and one time small staff infection at the beach. It all cleared up. I was fine until Oct 29th of this year, took a mountain trip with sinus trouble, ear popped and now having clogged ear feeling. Right ear only with buzzing and screeching sound now. For about 6 weeks, spent with an ENT in Charlotte after several hearing evaluations at my visit, he is pretty sure it is otosclerosis. Can this come on that sudden? Do I have otosclerosis? The doctor says I am not ready for surgery yet. He will recheck my ear in 4 weeks, and then maybe consider a small hearing device. I have no pain or balance problems. But sometimes, I hear my bones or something in the back if my ear/head make a sound. Help!

Answer :

Thank you for your inquiry. It’s difficult to be sure whether you have otosclerosis or the consequences of prior ear infections. Of course, there is more than one condition that can present with ear stuffiness and hearing loss. It is possible for it to start rather suddenly, or you become suddenly aware of something that has been slowly developing.

Otosclerosis is a problem that causes stiffening of the joints between the little hearing bones (ossicles) in the middle ear. This serves to muffle the sound as it goes from the eardrum, through the ossicles to the inner ear. It usually develops when you’re in the 20s and can cause a significant hearing loss. Otosclerosis is readily treated with surgery to replace these bones (stapedectomy) or with hearing aids.

Usually, the diagnosis becomes clearer as time passes, and with careful examinations. If it worsens, surgery or hearing aids are considered. If you send us a copy of your hearing test, we may be able to give you a better idea.

I hope this helps clear things up.

Best of Luck.

Neil M Sperling, MD

New York Otolaryngology Group

36A East 36th Street

New York, NY 10016

Associate Professor

SUNY Downstate

Brooklyn, NY

Q & A

Surgery for hearing loss

Question:

I’ve been wearing hearing aids for about 5 years n I still have trouble hearing people clearly, I’m 30 years old and was told as I get older my hearing would get worse. I would like to know am I eligible to have surgery to restore hearing?

Answer:

Thanks for your question. Today, luckily, there are many options for those of us with hearing losses. However, I cannot answer your individual question without knowing what kind of hearing loss you have.

Sensori-neural hearing losses involve damage to the nerves that control our hearing. This can be anywhere from the cochlea in the inner ear- into the brain where the impulses are decoded for us. Hearing losses of this kind are quite common- Most often, this type of loss is treated with the use of hearing aids. Newer digital aids offer exceptional improvements from older ones in terms of clarity. They should be matched to the needs of the individual by a hearing professional- for optimum results.

For those with severe or profound losses, today we are using cochlear implants. These transmit nerve impulses directly to the cochlea to improve hearing in those whose hearing losses can’t be well treated with hearing aids.

Conductive hearing losses are those involving the mechanical transference of sound waves to the inner ear. This can be caused by anything from wax, to holes in the ear drum, to problems with the hearing bones in the middle ear to fluid in the middle ear. These losses usually can be fixed- by removing the wax, repairing the hole in the ear drum, draining the fluid or by surgery to repair the hearing bones in the middle ear (stapedectomy).

Our website www.nyogmd.com has a section that explains how the ear works and hearing disorders in greater depth. Dr. Neil Sperling is the Director of Ear Care at NYOG.

Robert L Pincus MD

stapedectomy Archives - The New York Otolaryngology Group

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

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

Do I have otosclerosis?

Surgery for hearing loss