Surgery for Hearing Loss
The otology specialists at the Ear Institute of New York Eye and Ear Infirmary (NYEE) use the most advanced technology and techniques to correct defects and conditions that cause hearing loss or impairment. These include infection, benign tumors, trauma to the ear, deformities, and nerve pathway disorders that can affect both hearing and balance.
Surgical options include the latest minimally invasive microscopic and endoscopic ear surgery techniques for children and adults with routine and complex middle ear disease. Introduced in the 1990's, the use of endoscopes for ear and otologic surgery has steadily increased, and it is now a preferred tool for middle ear surgery. A minimally invasive procedure, endoscopic ear surgery allows the surgeon access to the middle ear through the ear canal (a natural ear opening) without the need for an incision behind the ear. At the Ear Institute, this unique method of otologic surgery is used for procedures such as tympanoplasty, cholesteatoma removal, and ossicular reconstruction.
Depending on the cause of your hearing loss and its severity, you may be eligible for a variety of surgical procedures. Most of these are performed at the Ear Institute on an outpatient basis, meaning you’ll be discharged the same day after a period of recovery and careful observation. Our board-certified physicians will make their recommendation on the most appropriate treatment following a thorough evaluation of your condition. Testing may include advanced imaging such as computed tomography (CT) or MRI.
The most common procedures we perform at our state-of-the-art surgical suites in Manhattan include:
- Tympanoplasty repairs or reconstructs a perforated eardrum (tympanic membrane), which separates the outer and middle ear, or the small bones of the middle ear. This perforation can result from chronic infection or trauma to the eardrum. Using general or local anesthesia, the ENT surgeon will usually take a graft from healthy tissue (typically on another part of the ear or in the hairline) to repair the damaged tympanic membrane. At the conclusion of surgery, the ear will be packed with dissolvable materials, and after about two to three weeks you will be reexamined by your surgeon to ensure the graft was successful.
- Stapedectomy improves progressive hearing loss from otosclerosis, a disease affecting a tiny bone (the stapes) of the innermost middle ear that vibrates and transmits sound from the middle to the inner ear. When the spongy bone around the base of the stapes hardens, the stapes no longer vibrates properly, impeding the transmission of sound signals. During a stapedectomy, the surgeon removes the stapes and replaces it with a prosthesis. A few weeks after the surgery, your doctor will remove the packing and reexamine the ear.
- Mastoidectomy removes the part of the mastoid bone (the prominent bone behind the ear) that has become infected as a result of ear infections (such as mastoiditis or chronic otitis) or inflammatory diseases of the middle ear (cholesteatoma). As with other types of ear surgery, you ear and mastoid will be packed with dissolvable materials that help the bone heal. Immediately after surgery, you will have a head bandage that is typically worn for approximately 8-12 hours.
- Cochlear implants bring sound to people with severe to profound hearing loss, who receive only limited benefit from hearing aids. Through an incision behind the ear the surgeon gains access to the inner ear and inserts tiny electrodes into the cochlea. These electrodes connect to an internal receiver, which is implanted by the surgeon under the skin above the ear. The electrodes stimulate the cochlea’s hearing nerve endings, bypassing damaged hair cells, and send the impulses to the brain, where they are interpreted as sound. Our physicians take special care during cochlear implant surgery to preserve the patient’s residual hearing so that afterwards a hearing aid together with the implant might be an option to optimize hearing.