The contralateral ear can be addressed surgically after a time span of 4-6 months. This complication has an unclear etiology. If suspected, initiate steroid therapy and taper over a 10-day course. Tinnitus may be more pronounced postoperatively, especially if hearing worsens following surgery. Facial nerve palsy is a devastating, and fortunately, rare complication.
Management typically is supportive only, unless symptoms suggest perilymphatic fistula.
Incidence of this complication has declined concomitantly with the decline of total stapedectomies. Laser use and abandonment of absorbable gelatin sponge have further decreased this complication. Most authors advocate sectioning the chorda tympani, if it intraoperatively is found stretched or otherwise injured, to decrease the incidence further. Tympanic membrane perforation is rare, and if it occurs during surgery, a fascial graft repair can be performed. Manage postoperative or persistent perforations by usual means.