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ENT · Ear and audiology: stapes surgery in only hearing ear
Sample itemA patient with bilateral otosclerosis requests stapes surgery. Which principle is generally followed when planning the operation?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Operate on the poorer ear first, and avoid operating on an only hearing ear
Stapedotomy carries a small risk of sensorineural loss. Operating on the worse ear first protects the better ear, and an only hearing ear is generally not operated, or only after careful counselling. Bilateral simultaneous surgery is avoided.
Option by option
A. Operate on the poorer ear first, and avoid operating on an only hearing ear (correct)
Correct. The poorer ear is chosen to limit the risk to useful hearing.
B. Operate only on the better hearing ear
The better ear should not be chosen first.
C. Always operate on both ears in the same sitting
Bilateral same-sitting surgery doubles the risk of bilateral loss.
D. Operate on the better ear first
Operating on the better ear exposes the useful hearing to risk.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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