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Stapedectomy - restoring hearing in otosclerosis.

Removal of the fixed stapes bone and placement of a small prosthesis to restore sound conduction. A consultant otologist, a proper operating microscope, and audiology in place before and after.

See indicative pricing
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Indicative pricing

What a private stapedectomy costs in the UK.

Indicative ranges across UK units.

In short

£6,500–£10,500, home day-case or one night.

Procedure Indicative range
Stapedectomy (unilateral, day-case) £6,500–£10,500
Stapedectomy with overnight stay £7,500–£11,500
Revision stapedectomy £8,500–£13,000
Diagnostic audiology package £250–£450
ENT consultation only £220–£400
Temporal bone CT (fine-cut) £450–£750

Prices vary by hospital, by the consultant, by approach, and by whether adjunct services are needed.

The problem

The right patient, the right prosthesis, and the right surgeon for a delicate ear.

Stapedectomy is a two-millimetre operation. Volume, microscope work and vestibular rehabilitation all matter - and general ENT lists rarely deliver all three.

  • A confirmed otosclerosis diagnosis first

    Air-bone gap on audiometry, normal tympanogram, absent stapedial reflex. The workup should be complete before consenting to surgery.

  • Prosthesis choice matters

    A fluoroplastic-platinum piston is the workhorse. Length and diameter are chosen intraoperatively - not from a catalogue.

  • Vertigo is not just the operation

    Short-lived imbalance is normal. Persistent vertigo needs vestibular therapy, not reassurance and a wait.

When it helps

When stapedectomy is the right step.

The situations that come up most, plus the one red flag that needs urgent attention rather than a routine booking.

  • Otosclerosis with conductive loss

    Progressive hearing loss with an air-bone gap, family history, worse in one ear - the classic profile for stapes surgery.

  • Mixed hearing loss from otosclerosis

    When cochlear otosclerosis is added to the fixation, stapedectomy still helps the conductive component. Expectations are set carefully.

  • Failed hearing aid trial

    A hearing aid that gives poor speech clarity or feedback, or that the patient will not wear - surgery becomes the better option.

  • Tinnitus with otosclerosis

    Tinnitus often improves after successful stapes surgery, though it is never a stand-alone indication.

  • Second-ear surgery

    A stable, well-hearing first ear at 6 months or more, and a patient who wants to close the gap on the second side.

  • Revision after prosthesis displacement

    A prosthesis that has slipped, extruded or become fibrosed. Revision is technically harder and is done only by high-volume otologists.

  • Young adults with hereditary otosclerosis

    Otosclerosis often shows up in the twenties and thirties. Surgery delays or prevents the need for aids for decades.

  • Red flag: sudden sensorineural loss

    Sudden severe hearing loss, spinning vertigo or facial weakness after ear surgery - same-day team or A&E, not routine follow-up.

Options

Approach and technique both depend on the indication.

What each option involves - the surgical or clinical approach, and how it is tailored to each patient.

  • Traditional microdrill stapedectomy

    The stapes footplate is removed and replaced with a prosthesis. The classic technique, still preferred in some hands for stubborn footplate anatomy.

  • Small-fenestra stapedotomy

    A tiny hole is made in the footplate rather than removing it. Lower risk profile - covered on the dedicated stapedotomy page.

  • Piston prosthesis

    Fluoroplastic-platinum piston, 4.0–4.5 mm long and 0.4–0.6 mm wide. The workhorse for both stapedectomy and stapedotomy.

  • Self-crimping designs

    Nitinol shape-memory pistons reduce incus trauma. Chosen by surgeon preference and revision anatomy.

  • Local versus general anaesthetic

    Local with sedation keeps the patient responsive so hearing can be tested on the table. Some patients prefer GA - both are safe.

  • Endoscopic stapes surgery

    An emerging minimally invasive alternative. Not yet standard in the UK - offered by a small number of high-volume units.

  • Revision stapedectomy

    For a displaced or fibrosed prosthesis. Success rates are lower and dizziness risk higher - reserved for experienced otologists.

  • Second-side surgery

    Offered when the first ear has settled with a good result at 6 months or more. Sequential, never bilateral in the same sitting.

Safety and recovery

What to expect afterwards - honestly.

A well-established treatment. The things worth planning are the approach, the aftercare and the follow-up.

  • Local sedation or GA - either is safe

    Local with sedation lets the surgeon test hearing on the table. GA is fine for anxious patients. Day-case is standard.

  • Hearing gain, and residual air-bone gap

    Around 90 percent of first-time cases close the air-bone gap to within 10 dB. A small number get partial gain or none.

  • Sensorineural loss - the one that matters

    Total (dead-ear) sensorineural loss occurs in about 1 percent of first-time cases. This is the risk that shapes the consent conversation.

  • Vertigo and imbalance

    Short-lived dizziness in most, settling in 1–2 weeks. Persistent vertigo needs vestibular rehabilitation, not reassurance.

  • Taste change

    The chorda tympani nerve runs through the field. A metallic or altered taste on one side of the tongue occurs in up to 10 percent and usually resolves in months.

  • Perilymph fistula

    A rare leak of inner-ear fluid causing fluctuating hearing or dizziness. Managed with bed rest first, revision if it persists.

  • Tinnitus - often better, sometimes worse

    Most patients report improvement. A small number find tinnitus louder after surgery - expectations are set honestly.

  • Second-ear timing

    No sooner than six months after a successful first side, and only with a stable audiogram. Bilateral same-day surgery is not standard.

  • Red flags after surgery

    Sudden hearing drop, spinning vertigo, facial weakness, foul-smelling discharge or severe pain need the same-day team or A&E.

Reading your notes

Your notes in four parts. Read the last one first.

Whichever approach was used, the note the consultant sends you keeps to the same shape.

A UK consultant reviewing a patient’s notes

A quiet reminder

Clinical language is precise and can read coldly - ask your care team to explain anything that is unclear.

If you would like the notes talked through before your review, ask your clinician.

  1. 01 Header

    Indication and side

    Which ear was operated on, why the operation was done, and whether it was a primary or revision procedure.

  2. 02 Technique

    Approach, prosthesis and findings

    Transcanal microscopic approach, the prosthesis type and length, and what the surgeon saw - footplate thickness, obliteration, any anatomical variant.

  3. 03 Findings

    Intraoperative hearing test

    Where local anaesthesia is used, an on-the-table hearing check documents the immediate improvement in air conduction.

  4. 04 Impression

    Aftercare and audiology plan

    Read this first: activity restrictions, when to fly, and the six-week audiogram appointment that confirms the gap has closed.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Stapedectomy is usually covered when medically indicated for otosclerosis with a documented air-bone gap. Revision surgery may need pre-authorisation.

Frequently asked

Common questions about stapedectomy.

Quick answers on suitability, technique, cost and recovery.

  • How much does a private stapedectomy cost in the UK?

    Roughly £6,500–£10,500 as a day-case, and £7,500–£11,500 with an overnight stay. Revision stapedectomy is £8,500–£13,000. Diagnostic audiology and a temporal bone CT are extra where needed.

  • How successful is stapedectomy at improving hearing?

    In first-time cases performed by high-volume otologists, around 90 percent of patients close the air-bone gap to within 10 dB - a real, measurable improvement in hearing. Revision surgery has lower success rates.

  • What is the risk of losing all hearing in the operated ear?

    Total (dead-ear) sensorineural loss occurs in about 1 percent of first-time stapedectomies. It is the single risk that shapes the consent conversation - which is why the worse-hearing ear is operated on first and the second side is spaced by at least six months.

  • Stapedectomy or stapedotomy - what is the difference?

    Stapedectomy removes the whole stapes footplate; stapedotomy makes a small laser hole in it. Modern practice favours laser stapedotomy in most cases, but traditional stapedectomy still has a role in specific footplate anatomy.

  • How long is recovery from stapedectomy?

    Back to office work in one week, back to full activity by 3–4 weeks. No swimming for 6 weeks, no flying for 4–6 weeks, and no heavy lifting or straining for 2 weeks. Driving when you feel steady - usually a few days.

  • Will I have vertigo after stapedectomy?

    Mild dizziness for a few days is expected and usually settles in 1–2 weeks. Persistent vertigo beyond that needs vestibular rehabilitation and a review with your otologist. Severe spinning with hearing loss is urgent.

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