otosclerosis and stapedectomy

[fancier]

Hello!

I want to know, is anyone here who had a stapedectomy op along of otosclerosis and now successfully diving (scubadiving or freediving)? Is it possible?
I have to decide between two alternatives: stapedectomy or hearing aid.
Stapedectomy is better for my, but I like freediving very match and hate to give up it!

Thanks

 

[BillP]

Hi fancier:

Sorry to be the bearer of sad news, but every dive medicine authority I know of says people who have had a stapedectomy should not dive. I believe this prohibition includes freediving too.

The stapes (also called the stirrup because of its shape) is a bone in the middle ear that helps conduct sound from the ear drum to the inner ear's hearing mechanism. It connects to the inner ear at a structure called the oval window. Stapes surgery increases the chance that the oval window will rupture due to barotrauma causing the normal fluid of the inner ear to leak.

Hope it works out for you.

Bill

 

[DocVikingo]

Hi fancier,

No arguing with Doctor Bill on this one. When one undergoes stapedectomy, the stapes is removed & replaced with an artificial one. During the removal, the small stapedius muscle which limits the movement of the stapes is taken down & cannot be reattached to the prosthesis. Exposing the ear to the pressures of diving, even free diving, could cause this freely moving stapedial device to puncture the oval window, a potentially very serious injury.

Sorry, Old Pippin.

DocVikingo

 

[fancier]

Thanks for answer!
Yes, I know : history of stapedectomy is absolute contraindication for diving and what is stapedectomy op.
Bat, surfing over Internet I sight than same surgeons make non-standard op and permit dive for patients (www.ear-sinusctr.com/otosclerosis.html or http://www.sciencenet.abc.fr/sciencenet/rightframe4gb.htm for example).
That why I thought in world mast be divers with history of stapedectomy.
It would be very interesting for me to hear theirs story and feeling.
Yours advise how can I find such folk?
Thanks

 

[scubadoc]

Strongly suggest that you contact the surgeons listed on the web sites that you have referred to for a consultation about their success rates for hearing loss, complications and morbidity of their procedures.

You should also request other opinions about this surgery from experienced ENT physicians.

Here is a favorable report on laser stapedotomy found in Medline: (I believe this procedure does not cut the tendon, thereby allowing the footplate to be stable while diving)

Lasers Surg Med 2001;28(1):11-17

Experimental and clinical results of Er:YAG laser stapedotomy.

Lippert BM, Gottschlich S, Kulkens C, Folz BJ, Rudert H, Werner JA.

Department of Otorhinolaryngology, University of Marburg, Germany. lippert@mailer.uni-marburg.de

BACKGROUND AND OBJECTIVE: At the beginning of the 1980s, different laser types were used for stapes surgery to reduce potential harm to inner ear structures through manipulation with conventional instruments during stapedotomy. Most clinical studies were carried out with the CO2 or the argon laser. The Er:YAG laser has been used rarely in patients with otosclerosis. STUDY DESIGN/MATERIALS AND METHODS: In an experimental study on 54 human petrous bones, the optimal laser energy parameter for dissection of the posterior stapes crus and the footplate perforation were determined. With these parameters, stapedotomy was carried out with the Er:YAG laser in 29 patients with otosclerosis with a conventional dissection of the incudostapedial joint and the stapedius muscle tendon. The Er:YAG laser was used (60 or 100 mJ, 3-6 pulses) for dissection of the posterior stapes crus and footplate perforation. RESULTS: No intra- or postoperative complications were observed in all 29 patients. Vertigo and hearing loss were not observed intra- or postoperatively. The postoperative hearing results (improvement of the air-bone gap) was in all cases satisfactory (median remaining air bone gap, 8.1 dB). The median operation time was 29 minutes (15-42 minutes) and did not show a significant prolongation in comparison to the conventional technique. In 1 of the 29 patients, the footplate perforation needed to be carried out conventionally. CONCLUSION: For the first time, Er:YAG laser parameters have been optimized and refined in a human petrous bone model and were then used in a clinical setting. According to the presented results, the Er:YAG laser seemed to be a very suitable instrument for stapedotomy.

scubadoc
Diving Medicine Online
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Answers are for information only, do not imply diagnosis or treatment and should always be used in conjunction with the advice of you personal physician.