Has anyone else with otosclerosis tried to have stapedectomy but have the doctor decide in the middle of the operation that it can't be done?

My 24 year old brother, was diagnosed with otosclerosis when he was in his
mid teens. He needs a hearing aid to hear properly unless people speak
loudly to him. His doctors have been recommending stapedectomy
to him for the past 5-6 years. After his doctor told him that the procedure
would have a 90% chance of success for him, he tried to get a stapedectomy
yesterday. However,
after opening his ear, the surgeon found that his ear bone is fused with the
nerve, so he decided not to perform the surgery and closed up the ear! The surgeon
also said that he put a pack in my brother's ear and will remove the pack
after 2 weeks. In the meantime, my brother cannot hear from that ear at
all.

Is it true that if my brother's ear bone is fused with a nerve, that the
stapedectomy surgery cannot be performed? If so, then what other treatment
options are available? Would sodium fluoride help?

kjhashim,

There are, as you said, 10 % of the people who get no better after surgery. Presumably the reason has to do often with a disease that has progressed to far or invaded the worst places-like nerve or cochlear tissue-often, most unfortunately, sealing the ROUND WINDOW tight. This is the cochlear VENT and is as necessary as the oval window for hearing but surgeons cannot reach it.

Here's what I'd recommend (not a doctor) for your brother. Get an MRI on the OTHER ear and have a CRACK ototsurgeon give his opinions....even if it means sending them to another country. The second ear might be quite amenable to surgery. There's no reason to believe it's identical to the first.

In any case DON'T consider FOR A MOMENT using the same surgeon again. He may be touted to the skies by his peers, but as far as your brother goes, he has a track record of EXACTLY ZERO PERCENT! Also this guy should have suggested MRI before the first surgery especially since your brother showed symptoms so early (at 24.)

An aside: what I know about nerves is that there's a nerve of taste that passes directly behind the eardrum right through the crook of the "hammer" bone. It must be teased aside for the surgeon to get his tools in. In my case I got (and still have after a month) a slight extra "saltiness" on the sides of my tongue...from the banging around with that nerve. I'm getting used to it though.


[This message has been edited by zip2play (edited 07-20-2003).]

I have read that in this case a good doctor shouldn't perform a stapedectomy as it will lead to total deafness.
I do not know whether it is possible to predict the nerve fusion to the hearing bone before the operation but I agree with Zip on having a second opinion about this.
I hope that your brother has preserved the hearing he haid before the operation. He will be able to tell after they remove the packing.
You can always try to operate the other ear but do have a second opinion about this.
We are not doctors just have been reading a lot about oto as we are diagnosed with the same condition.
Keep us posted and good luck!

When nerves are fused to a bone it is more than likely that permanent damage may be done by trying to unfuse a nerve from a bone. Your brother may be wise to get a second opinion but in my opinion the surgeon who operated used very good judgement since more damage then good would have obviously been done if he had tried to free that nerve and proceed with the operation. One thing your brother needs to do though is ask the doc just what kind of permanent damage would have been done if the doc had tried to free that nerve that was fused to the bone. You cannot always predict what you will find when you open someone up during surgery and the surgeon obviously didn't know that a nerve was fused to the bone. I am not sure if that would have even shown up on an MRI.