Questions often arise about stapedectomy and pregnancy. In the following video, Dr. Light addresses the timing of surgery for otosclerosis relative to pregnancy. He specifically addresses whether becoming pregnant after surgery can negatively affect the outcome of a prior surgery.
In a stapedectomy surgery, the stapes bone is partially removed and a hole is created at the footplate of the stapes so that a piston can be inserted.
At that point, and this is a very important point, once the piston is in place, sound is conducted from the ear canal to the eardrum to the malleus, then to the incus and the piston goes in and out transmitting the vibration to the inner ear so that the stapes is not participating in the conducting of that vibration to the anymore even though the footplate of the stapes is still in place and is still rigidly fixed and incapable of vibrating, it no longer matters because the vibration is being transmitting via the piston which bypasses the stapes footplate by going through that stapedotomy, that opening.
This is relevant to pregnancy – while some doctors feel that pregnancy does not affect otosclerosis – others do, and among those that feel that otosclerosis does potential cause – an acceleration during pregnancy, it occurs because of the freezing or fixation of the stapes footplate. In other words, if pregnancy does affect otosclerosis – if it makes it worse – the way it makes it worse is the way it makes it worse is because it accelerates the bony overgrowth around the footplate that causes it to become locked…so that if a person has not had surgery, the conductive hearing loss from the fixation of the stapes will deteriorate if the pregnancy causes this accelerated bony growth.
However, if a woman has had a stapedectomy done prior to her pregnant then even if the bony overgrowth from around the footplate does accelerate during preg it doesn’t matter
because the piston is now bypassing the stapes entirely, so no matter how rigidly fixed the stapes footplate is, the sound is still being conducted normally via this new mechanism, the piston that was placed in.
So for those of you concerted about waiting until after pregnancy because you’ve been told
the otosclerosis may get worse during pregnancy, I would say this is misguided advice because at the time of the stapedectomy we are making that stapes footplate irrelevant – it is no longer is participating in the conduction of sound energy so no matter what happens during pregnancy with regards to the stapes bone the stapedectomy will still be working the same either before or after the pregnancy.
If you would like a consultation relating to stapedectomy and your pregnancy, feel free to contact us.