OTOSCLEROSIS AND Stapes surgery

Otosclerosis is a condition where abnormal bone growth in the middle ear prevents the tiny bones from vibrating freely. This interferes with sound transmission, leading to a gradual loss of hearing — often starting in one ear and progressing over time.

It usually affects adults aged 20–50 and often runs in families.

The exact cause of otosclerosis isn’t fully understood, but it’s believed to be linked to a mix of genetic and environmental factors. It involves the stapes bone in the middle ear becoming fixed in place, rather than vibrating freely to transmit sound.

• Progressive hearing loss (often following a pregnancy)
• Tinnitus (ringing or buzzing in the ear)
• Hearing better in noisy environments
• Difficulty following conversations

Diagnosis usually includes:

• Examination of the ear
• A detailed hearing test (audiogram)
• Tympanometry (to check eardrum and middle ear movement)
• Sometimes a CT scan for surgical planning

There are two main ways to manage otosclerosis:

1. Hearing Aids

Many patients with mild to moderate otosclerosis benefit from high-quality hearing aids, which amplify sound and can dramatically improve clarity in daily life.

2. Stapes Surgery (Stapedotomy)

If hearing aids aren’t sufficient or preferred, surgery may be the best option. This delicate operation replaces the fixed stapes bone with a tiny prosthesis that restores the natural movement of sound. I offer this surgery awake or under general anaesthesia, with patients going home the same day. Surgery is performed through the ear canal with no external cuts required in 100% of my patients to date.

As one of the few UK surgeons offering awake stapes surgery with local anaesthesia, Mr Patel prioritises:

• A gentle, patient-focused experience
• Fast recovery
• Modern, minimally invasive techniques
• Honest, personalised advice on when surgery is (and isn’t) the right choice
• He has extensive experience with managing both primary (first time) surgeries along with revision surgeries. We also have a breadth of experience managing rare and complex variations of stapes surgery

Mr Patel was featured on BBC News due to this unique combination of cutting edge, minimally invasive and effective care. 

Hearing Outcomes

Mr Patel is among the UK’s highest volume stapes surgeons performing approximately 50 such cases a year. On the basis of his case series to date:

- 94% of patients have an improvement of hearing to within 10 dB Air bone Gap

- 98% of patients have an improvement of hearing within 20 dB Air Bone Gap

- 2 % have no significant change

- 0% have experienced a complete hearing loss though the risk of this is approximately 1%

Surgery lasts on average 34 minutes (varying from 12 minutes to 94 minutes depending on complexity)

0% of our patients have required any external cuts as the procedure has been performed completely through the ear canal.

100% of our patients have had surgery under local anaesthesia with or without sedation. The advantage is that we are able to test hearing on the table to ensure a good hearing result. 

Patients are also able to make a swifter recovery following the procedure and are able to return home sooner.