Concierge ENT · UK
Laser stapedotomy - a tiny hole, a big hearing gain.
A modern refinement of stapes surgery. A precise laser fenestra is made in the footplate and a piston is placed through it. Less traumatic than classical stapedectomy, and now the default in most UK units.
Why patients choose us
- 01
A dedicated laser suite
CO2 or KTP laser, an operating microscope and a consultant otologist who does this list every week. Precision drives outcomes.
- 02
Vestibular pathway built in
Post-operative dizziness is planned for - an early vestibular therapy referral is part of the package, not an afterthought.
- 03
Independent, and free
We are paid by no clinic. Whether a hearing aid trial fits first is said out loud, and costs you nothing.
Indicative pricing
What a private stapedotomy costs in the UK.
Indicative ranges across our partner units. Send the details and we quote firm figures across two or three options, with cover checked.
In short
A day-case laser stapedotomy in our network: £7,000–£11,000, home day-case or one night.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Laser stapedotomy (day-case) | £7,000–£11,000 | 45–75 min | Day-case or 1 night |
| Laser stapedotomy with overnight stay | £8,000–£12,000 | 45–75 min | 1 night |
| Revision laser stapedotomy | £9,000–£14,000 | 60–120 min | 1 night |
| Audiology package (pre-op) | £250–£450 | 45–60 min | Same visit |
| ENT consultation only | £220–£400 | 30–45 min | Same visit |
| Vestibular assessment | £350–£600 | 45–60 min | Same visit |
Prices vary by hospital, by the consultant, by approach, and by whether adjunct services are needed. We come back with a firm quote within one working day.
The problem
Small fenestra, precise laser, gentle inner ear.
Laser stapedotomy has taken over from classical stapedectomy in most units for good reason - lower vertigo, lower sensorineural loss, and quicker recovery. It still needs the right surgeon and the right laser.
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Laser precision beats mechanical drilling
A 0.6–0.8 mm laser fenestra spares the inner ear and reduces the drop attacks and vertigo of older techniques.
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The piston must fit
Length and diameter are chosen on the table. A piston that is too long causes vertigo; too short leaves a residual gap.
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Vertigo planning is part of the operation
Vestibular therapy is booked in advance in case the inner ear complains - not offered only if you ring afterwards.
The journey
From enquiry to recovery - what happens, in order.
One team from first message through follow-up and rehabilitation.
Phase 1 · Before your treatment
Assessment, imaging and planning
Phase 2 · On the day
Treatment and recovery
Phase 3 · After
Review and follow-up
- 01
Before
Your first message
A short, confidential form: hearing history, prior audiograms, tinnitus, family history.
- 02
Before
Recommendation and price
Within one working day: the consultant otologist, laser type, indicative price, and whether stapedotomy or classical stapedectomy suits your anatomy.
- 03
Before
Diagnostic audiology
Pure-tone, speech, tympanometry, stapedial reflexes. Temporal bone CT if needed.
- 04
Before
Consent and side selection
Worse-hearing ear first. Local sedation is often preferred so hearing can be tested during surgery.
- 05
On the day
Theatre
Same-day admission. Microscopic transcanal approach. A precise laser fenestra is made - 45–75 minutes.
- 06
On the day
Recovery
Home the same day or after one night. Antiemetic on hand, ear packing, written aftercare.
- 07
After
Six-week audiogram
Wound review at 1–2 weeks. Audiogram at 6 weeks confirms closure of the air-bone gap.
Typical end-to-end: 2–4 weeks from enquiry to treatment.
When it helps
When stapedotomy is the right step.
The situations we see most, plus the one red flag that needs urgent attention rather than a routine booking.
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Otosclerosis with a documented air-bone gap
Classic profile - progressive conductive loss, absent stapedial reflex, family history.
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Thin or fragile footplate
A small-fenestra laser approach is safer than removing the whole footplate.
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Patient preference for lower vertigo risk
Where stapedectomy and stapedotomy both fit, most patients now choose stapedotomy.
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Aid failure or intolerance
A hearing aid that gives poor speech clarity, feedback, or that will not stay in - surgery becomes the better option.
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Second-ear surgery
A stable, well-hearing first ear at 6 months or more, and a patient who wants the second side closed.
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Revision stapes surgery
For displaced or fibrosed prostheses. Laser precision helps in scarred fields - done only by high-volume otologists.
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Bilateral otosclerosis in young adults
Where hearing aids will otherwise dominate the twenties and thirties, staged bilateral stapedotomy can be transformative.
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Red flag: pulsatile tinnitus with vertigo
Consider superior canal dehiscence or a vascular cause - an MRI and dedicated CT before any surgery.
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.
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CO2 laser stapedotomy
Delivers a controlled ablation with minimal thermal spread. The dominant technique in high-volume UK units.
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KTP laser stapedotomy
A visible-light laser with excellent haemostasis. Chosen by surgeon preference and available platform.
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Microdrill stapedotomy
Mechanical alternative when a laser is unavailable. Slightly higher vertigo risk than laser.
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Fluoroplastic-platinum piston
The default prosthesis. Sized 4.0–4.5 mm long and 0.4–0.6 mm wide on the table.
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Nitinol self-crimping piston
Shape-memory alloy piston that avoids mechanical crimping - reduces incus trauma.
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Local sedation approach
Awake sedation with intraoperative hearing testing. Improves piston length choice and outcomes.
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General anaesthetic approach
For anxious patients or long revision cases. Outcomes are equivalent in experienced hands.
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Endoscopic-assisted stapedotomy
An emerging approach using rigid endoscopes. Offered by a small number of specialist centres.
Our vetted UK network
A small panel of specialists, we picked them.
Consultant-led services across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every specialist in our network.
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Consultant otologists doing weekly stapes lists - not occasional ENT operators
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CO2 or KTP laser on site, plus a modern operating microscope
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Awake sedation and GA both available so approach can be tailored
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Vestibular therapy and audiology on site for pre- and post-operative work
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.
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Sensorineural loss is rare with laser
Total sensorineural loss is under 1 percent in high-volume laser hands - lower than classical stapedectomy in most series.
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Vertigo is usually short-lived
Mild dizziness for a few days is normal. Persistent spinning needs vestibular therapy and an audiogram check.
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Taste change
Chorda tympani manipulation causes a metallic taste in up to 10 percent. Most cases settle over months.
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Piston displacement
A displaced or extruded piston causes a return of the air-bone gap. Revision is possible but harder - done by high-volume operators.
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Perilymph fistula
A rare inner-ear fluid leak causing fluctuating hearing or dizziness. Bed rest first, revision if it persists.
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Tinnitus outcomes
Most patients report tinnitus improvement. A small number find it louder - set expectations honestly.
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Second-ear timing
No sooner than six months after a stable first side. Never bilateral in the same sitting.
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Flying and diving
No flying for 4–6 weeks, no diving for 3 months. Cabin pressure changes must be managed carefully.
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Red flags after surgery
Sudden hearing drop, spinning vertigo, facial weakness or foul-smelling discharge - 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 quiet reminder
Clinical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the notes before your review, just ask.
- 01 Header
Indication and side
Which ear, why the operation was done, laser type used, and whether it was primary or revision.
- 02 Technique
Fenestra and prosthesis
Fenestra diameter, piston length and diameter, and how it was fixed to the incus.
- 03 Findings
Intraoperative hearing test
Where sedation is used, an on-the-table hearing check documents the immediate improvement.
- 04 Impression
Aftercare and audiology plan
Read this first: flying restrictions, activity limits, and the six-week audiogram appointment.
Recognised by major UK insurers
Laser stapedotomy is usually covered when medically indicated for otosclerosis. Pre-authorisation may be needed for revision. We confirm cover before booking.
Frequently asked
Everything we get asked about stapedotomy.
Quick answers on suitability, technique, cost and recovery.
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How is stapedotomy different from stapedectomy?
Stapedotomy makes a small laser hole in the stapes footplate and inserts a piston through it. Stapedectomy removes the whole footplate. Stapedotomy is now the default in most UK units - it causes less vertigo and lower sensorineural loss risk.
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How much does laser stapedotomy cost privately in the UK?
Roughly £7,000–£11,000 as a day-case, and £8,000–£12,000 with an overnight stay. Revision cases range £9,000–£14,000. Diagnostic audiology and CT are extra. We confirm a firm figure within one working day.
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What are the success rates?
In experienced laser stapedotomy hands, around 90–95 percent of patients close the air-bone gap to within 10 dB and report a real, everyday improvement in hearing.
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How is it different day-to-day from a hearing aid?
A well-fitted hearing aid amplifies sound in the ear canal. Successful stapedotomy restores the mechanical link across the ossicles - no battery, no daily fitting, no feedback. Both are valid; we discuss the trade-off honestly.
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When can I fly after stapedotomy?
Most surgeons ask you to avoid flying for four to six weeks. Cabin pressure changes can dislodge the piston or aggravate the inner ear before healing is complete. Discuss travel plans before you book surgery.
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Is bilateral surgery possible?
Yes, but sequentially. The second ear is done no sooner than six months after a stable and successful first side. Same-day bilateral surgery is not standard practice.
Related treatments
Looking for something else?
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Stapedectomy
Traditional stapes footplate operation.
Learn more -
Cochlear implants
For sensorineural loss beyond stapes surgery.
Learn more -
Hearing aid fitting and repair
Fitted amplification as a first step.
Learn more -
Hearing therapy
Vestibular and hearing rehabilitation.
Learn more -
Ear infection treatment
When infection complicates otosclerosis planning.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more