Which one of the following procedures is used to correct otosclerosis?

Appeared in: AIIMS Patna NO - 2020

Explanation

Otosclerosis is a primary disease of the middle ear bone where abnormal spongy bone growth immobilizes the stapes, causing progressive conductive hearing loss.
Stapedectomy is the specific surgical procedure designed to correct otosclerosis.
The procedure involves the microsurgical removal of the fixed stapes bone and its replacement with a prosthesis, thereby re-establishing the pathway for sound conduction to the inner ear.

Option A: Myringoplasty is the surgical repair of the tympanic membrane (eardrum).
Option B: Myringotomy is an incision into the eardrum to drain fluid.
Option C: Mastoidectomy involves the removal of diseased mastoid air cells behind the ear.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Surgical management of otosclerosis as background academic context rather than a clinical decision trigger.
Post-stapedectomy nursing care is crucial for a successful outcome. Key interventions include assessing for complications like vertigo, nausea, and facial nerve injury, as well as educating the patient on activity restrictions.
Patient safety is a priority. If a patient experiences vertigo post-operatively, the nurse must implement fall precautions, assist with ambulation, and ensure the patient understands not to get up without help.
What if? If a patient post-stapedectomy reports a sudden increase in hearing loss and severe vertigo, the nurse should instruct the patient to lie flat and immediately notify the surgeon. This could signify a displaced prosthesis, which is a surgical emergency.

How to Approach the Question

First, identify the key pathology in the question stem, which is 'otosclerosis'.
Recall the pathophysiology of otosclerosis: it specifically affects the stapes bone in the middle ear, causing it to become fixed.
Examine the surgical terms in the options. Look for a term that relates to the stapes bone.
The term 'Stapedectomy' contains 'stape', referring to the stapes bone, and '-ectomy', meaning removal. This directly links the procedure to the affected anatomy.
Eliminate the other options by recalling their anatomical focus: 'Myringo-' refers to the eardrum (tympanic membrane), and 'Mastoid-' refers to the mastoid process.
By matching the pathology (otosclerosis of the stapes) with the corresponding surgical procedure (stapedectomy), you can confidently select the correct answer.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 pp. 70-72, 68-70

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