by Neil Bauman, Ph.D.
Otosclerosis (OH-toe-sklare-OH-sis) is a condition where spongy bone grows in the middle ear and often “fixes” the stapes (stirrup), the third bone in the middle ear, to the oval window so it can’t vibrate freely. The result is a conductive hearing loss. To correct this condition, an ear specialist performs a surgical procedure called a stapedectomy (stay-pee-DEK-toe-me). He typically removes the fixated stapes and replaces it with a plastic or metal prosthesis.
Now comes the insidious part. If the prosthesis contains any magnetic metal (iron, steel, stainless steel, nickel, cobalt), then you mustn’t have an MRI or you can totally destroy your life in a heartbeat and never know about it until too late. This actually happened to “Stephanie” (not her real name). Here is her story. She writes:
I came upon your article “Protect Your Balance System—Or Else…” and was so happy to find something that describes me so well.
Five years ago I had a MRI done. I explained to the attendant that I have a wire [the stapes prosthesis] in my inner ear to help with my hearing loss. (I had this surgery back in 1972. I had it looked at again in 1985.) However, in 2004, the hospital did a CT scan and said there was no wire there. I then had the MRI. Immediately upon coming out of the machine, I discovered I had lost my balance. I could not walk. I was nauseated, I could not hear as well, and the noise in my head was unbearable.
To make a long story short, I had to have emergency surgery on my ear to see if any fluid was draining [perilymphatic fistula]. I then had to take physiotherapy for two years for my balance. My eyesight also changed 50%, but has since gone back to the way it was.
After this fiasco, the hospital had another look at my CT scan and they saw the wire but it was too late. Please let people know just how much damage can be done to your body if doctors miss finding this metal prosthesis.
My ENT said the damage to my inner ear was like getting hit in the head with a baseball bat at full speed. (That is what the tiny stapes prosthesis did to my inner ear under the influence of the powerful magnets in the MRI machine.)
I have come a long way in healing but I still have issues. I am still learning everyday about things I cannot do. My first time going to a movie after the MRI was a disaster. I had to keep my head down during most of the movie. I was sick to my stomach, and my head felt like it was spinning. But I did not know this was from the damage caused because of the MRI and having a wire in my head.
I also lost more hearing in my ear. But it is different now than before. I can hear sounds, but I cannot tell where they are coming from. You can be right behind me talking but I do not know where you are. I call out to the person (usually my family) asking where are you. (To them, this is funny but it certainly gets to me at times.)
Also, if two people are talking, I cannot tell what they are saying. I can hear their voices, but the sounds are jumbled together.
If I am talking on the phone and another noise presents itself (like someone asking something of me) I lose the conversation on the phone and I don’t know what the other noise is, or what the person has said. Trying to cope in public—talking to people—is difficult. Ordering a coffee, lunch, etc. with noise around me is very hard. To see the look on the other person’s face, like I am retarded, is hard on me. I usually get my husband, or my girls, to order for me instead. It makes me want to stay home because it is the only place I am comfortable. Needless, to say, I have not returned to work.
You talk about the emotional side of hearing loss, and until you go through this yourself, it is hard for other people to understand. My family is still trying very hard to understand what I can no longer do.
I can no longer multi-task. I cannot do two things at once. After 5 years, I still see this in my everyday life. For example, I cannot walk down the stairs with something in each hand. I have to put my body against the wall to steady myself and even then it is difficult, and my legs are very shaky. I cannot ride a bike anymore. It was such a shock to me when I first tried. My hands were shaking the handle bars back and forth with such force, that I could not stop. (I keep trying every year, but it is the same every time, and has not improved.) I will never get on a circus ride again in my life.
Walking is interesting. I feel every dip or hump in the road or sidewalk that no one else feels. My body thinks I just stepped down into a two foot hole, or I will not notice when the pavement has gone up and I stumble. I constantly “bump” up against my husband when we are walking together.
When I am in a store shopping, I cannot look at something one way and then turn my head to the other side because I get dizzy and it feels like I am being quickly shoved. This feeling goes away quickly, but if I continue to turn my head side to side, I get “shoved” again. Think how many times you turn your head side to side in a day.
When I stand in the shower, I plant my feet firmly against the sides of the tub, so my hands are free to wash my hair. I can keep my eyes closed a little while now—long enough to rinse the soap out.
And yes, when the lights are out or dimmed, I hold onto furniture, walls, etc. to get around.
You talked about memory and being distracted. I have been telling my husband I don’t “feel smart” like I used to. I have trouble finding words to have a conversation. I have to look at the person talking with such an intense stare, and try as hard as I can to hear and understand and remember what they are saying. It is so hard to understand why I am like this and explain to my doctor, or husband, or family that I feel dumb. I knew there was something wrong, but did not realize it was related to the damage done to my inner ear.
Needless to say I have slowed down in life, which is why I only feel comfortable at home.
Sometimes when I feel “down”, I think my family is better off without me and my problems. I know this is not true, but I can’t help feel like that at times. I have given them a copy of your article and asked them to read it. I think what makes all of this so difficult, is the fact that if you look at me, I look perfectly “normal” but I’m not.
“Stephanie’s” tragic story reveals the enormous life-changing differences that can result from destroying the inner-ear hearing and balance mechanisms in just one ear (and its even worse if it happens in both ears).
Therefore, if you’ve had a stapedectomy where a magnetic metal prosthesis was put in your middle ear, do not ever allow an MRI to be done on your body. Some of the prostheses used in stapedectomies are now made of plastic or real bone or titanium. If that is your situation, having an MRI shouldn’t be a problem, but check with your ear doctor to be sure.
Finally, some real evidence to support what I suspected … had a stapedectomy; don’t get an MRI.
The interesting part is that “Stephanie†experiences many of the same hearing related symptoms that I do, and I have not had a MRI. Things like not being able to identify the direction a sound is coming from and difficulties with multiple voices may just be part of having a stapedectomy. At least it is for me.
Hi Jim:
Not being able to tell where sound is coming from has nothing to do with having an MRI, or a stapedectomy as such. It is because you have a worse hearing loss or no hearing in one ear. Thus only one ear hears a given sound. When that happens, you can’t tell from which direction it is coming.
You can have this same effect if you are hard of hearing in both ears, but only wear a hearing aid in one ear.
Likewise, having difficulty hearing multiple voices is a result of having a hearing loss, not the stapedectomy as such. This is one of the most common complaints of hard of hearing people.
Regards
Neil
If the MRI displaced the McGill prosthetic, manufactured without enough nickel and magnetic, then the hearing can be impacted by the MRI. Frankly, I’m surprised by your answer.
Hi Daniel:
Nobody mentioned a McGill prosthetic so I don’t understand why you are surprised by my answer.
Cordially,
Neil
is it good to get surgery done for otosclerosis? does a chronic infarct in right temporial lobe cause tinitus and hearing loss in right ear?
This is so confusing. Have had stapedectomies, both down in the 1970’s with great results. Right ear has gone “fuzzy” and doctor wants an MRI for a neuroma. I am scared. What kind of prosthesis did they use then? Any advice from anyone?
had stapedectomy done in
l978 , the prosthesis called robinson 4.5 mm bucket handle.
I was told it was made out of steel and should not get mri…also suffering from unbalancing problems ,and lightheaded ever since, any advise from anyone?
Contact the Doctor that did the surgery, They should have it in their files. I had mine done in1981. I have the old style so I can’t have the MRI so desperately need for lower back pain. Even if he has retired his partners could have his files. If they are gone you can try to find which manufacturers of the implant sold in your area. They may have a record of an implant being sold for you. For those with the old style contact your doctor they may be able to replace it with the new type so check. It you need to change up to get an MRI your insurance may cover it as a medical necessity. Mine would have except my inner ear bones have deteriorated too much to hold an new implant.
I had a stapedectomy done over thirty years ago. It was successful. I have refused to have a MRI done over the years, was never informed of the danger. I just felt and later had it confirmed that it was dangerous. Now my question. I have a device on my sewing machine with four extremely powerful magnets for embroidery. People with pacemakers should not use them. How about me?
Hi Patricia:
If your prosthesis used in your stapedectomy is made of iron, steel, cobalt or nickel, then it is one of the magnetic metals and putting another strong magnet close to that ear could “pull” the prosthesis out of place.
The reason why you should not use your embroidery gizmo if you have a pacemaker is that the front left magnet could get too close to your pacemaker and cause it to malfunction as you are leaning in doing embroidery–at least that is the way I see it.
However, your prosthesis in your middle ear is quite a bit higher on your body than is a pacemaker so the magnetic field should be too weak at that distance to cause any trouble–UNLESS you put your head down near it with that ear near a magnet.
As I see it, you should be safe, just keep the ear with the stapedectomy a foot or so away from any of the strong magnets. You might want to confirm this with an ear specialist to have a second opinion if you are still worried.
Regards
Neil
Is there a way to tell if you have a metal stapes after a stapedectomy (done in 1986)? I have contacted the hospital for my records; however, they have archived them. Should I wear a Medical bracelet in case of accident stating as such?
Hi Lind:
I really can’t help you there. I know some are metal, some are “plastic” and some are real human ear bones. Only your doctor/hospital would know for sure.
Regards
Neil
The hospital where your surgery was performed should have an implant log. I had this same issue. Years after my surgery I needed the info and records were archived, I paid the fee and filled out the paperwork and they sent me all the records and Dr. notes. My Dr had retired and moved away. I was able to get the MRI because the stakes used was made out of titanium. I was still very nervous after all the warnings about the metal ones.
Thank you. That is just my situation.
THANK YOU from the bottom of my heart. My husband has been scheduled to have an MRI in a couple of weeks and he is now going to cancel it. He had a stapedectomy in 1980. I ran across this site while looking to find out what an MRI is.
I had a couple stapendectomys several years ago They want to do a coachlear implant and requsted an mri My problem Is there a wire in my ear The drs I had at osu andrew miglets and dr welling nobody can get info on what kind of prothesis was put in Why cant my records be located and these drs can not tell if mri would hurt me I have had a few mris no problems but just today I went to Stephanie speilman breast cancer for mri I was told the solution for an mri is stronger then others and refused to do mri cause we couldnt find my records to show what kind I had ? So frustating when I left I know the years have gone by but what happens to all this records if your dr retires or passes on! My first stapendectomy was in the 80s 92 and 2007 no records ???? What to do !!!???
Had one done in l978, have my records , robinson 4.5mm bucket handle
Same problem as Roberta.
Some sites report that when you had your stapedectomy if they used a McGee piston it’s metal. So don’t have an MRI
Can a CT scan of one’s sinuses (including ears) be used to determine if the prostheses was made of bone or metal. I had both ears done in 1975 with great results. I have avoided MRI’s up to this point, but I wonder, that if my prostheses is bone, might I be able to have an MRI?
Hi Sue:
If your prostheses are of bone, you should be eligible for an MRI. With MRIs, you have to stay away from magnetic metals such as iron, nickel and cobalt. If your prosthesis is made of titanium, then typically you can have an MRI. Note that titanium can distort/obscure details near it.
Cordially,
Neil
Yes, but I would like to know if a CT scan of the sinus area (incl. ears) be used to determine if the prosthesis was bone or metal such as stainless steel ( both of which were used in 1975.
Hi Sue:
Ask your doctor. That’s the quickest way to find out. I’m not a medical doctor so don’t know all the things a MD knows.
Cordially,
Neil
Wow, glad I read all this. I was scheduled for an MRI for my shoulder, and was actually AT the clinic in a gown, ready to go in, when on a whim I mentioned that I had a stapedectomy in both ears, years ago. They immediately said I wouldn’t be allowed, and after reading the article, am very glad. It would have seriously ruined my life.
I was to have an MRI today but when I told them I had a stapedectomy also in both ears they said no they would not do an MRI, after reading these posts I am so glad. I have lost all hearing in one ear this is the reason I was to have the MRI to find out why, I would have been devastated to have something go wrong and lost all hearing. My operations where not done together one in the 70’s and one in the 80’s so different implants may have been used a bit hard to go back so far to find out whether they are MRI compatable . . Thanks to all these posts MRI’s are definitely out
I had exactly the same situation. I’ve had a stapedectomy in both years done ten years apart late 70s and 80s. A year ago I was just about to do an MRI when fortunately someone noticed that, on the form I had just filled in, I stated that I had a double stapedectomy. The MRI was immediately canceled.
I had a Stapedectomy in 1966 and the Dr. said in was a stainless steel wire. I was scheduled for a MRI two years ago and filled out the form and indicated what was done and nothing was said. I asked the tech about it when he called me in, that ended the MRI. I later talked to a friend who is a retired surgeon and he said that I can never have a MRI. I’m glad I said something!
Hi David:
Good thing you spoke up. Stainless steel is magnetic and you don’t want an MRI if you have any magnetic metal in your body.
Cordially,
Neil
I had a Stapes prostheses fitted in 1986 in Homestead Air Force Base, Florida. Before I have an MRI, I am advised to find out the name/type of prostheses. Would anyone know the type used back in 1986? Many thanks, Bev
you can have another scan in a similar machine that detects metal before you have an MRI, I had one and it found no metal. I’m having another mri scan for my neck soon.
This is just what I needed today! I have Stapes in both ears in 1983 & 84. Never had a problem with an MRI before. But now the magnets are stronger and more powerful I can’t ever have it again. Made phone calls to try and locate my medical records after 35 years but the ENT is now deceased and there is no record any where. I do remember him telling me that there was stainless steel in them so that’s an absolute NO! An MRI would be much better for what the doctors need to see now but a C.T. is going to have to do from now on. Who would have thought about that 35 years !
Does anyone know if they can take out the metal staple? I had this done over 30 years ago and am completely deaf now so it doesn’t help me. I want to be able to have mri’s if needed ( I need one now and am glad I found this link).I am thinking of asking the dr to take it out. Anyone experience that yet ? It is possible to remove these metal pieces ? Thank you
Hi Karen:
You can ask your ENT to remove it. If they put it in, they can also remove it.
Cordially,
Neil
I had a titanium prosthesis in my from a surgery in my ear from 2016. Can i get an MRI with titanium in my ear?
Hi Zaya:
Since titanium is not magnetic, I think you won’t have any problems. However, be sure to mention the titanium prosthesis to the technician and have him double check that it is ok.
Cordially,
Neil
Does anyone know if titanium was used for any prostheses in 1983? My doctor told me at the time it was titanium, but neither he nor the hospital still have records to verify it.
I’m scheduled for a brain MRI today. I have a Robinson’s Bucket Handle prosthetic from 1993. My question is this: does anyone know what Robinsons are made of? e.g. metals? My ENT moved to Asia shortly afterwards and no one seems to know. Thanks in advance.
I am a retired ear surgeon. The Robinson bucket handle stapes prosthesis was typically made of stainless steel, so to be safe you should NOT have an MRI.
I had stapedectomies in both ears in 1977-78. I was told the prothesis were stainless steel. Is there an MRI that’s safe for people like me? The hospital did a CT scan of my ears and said no metal showed up in test. I know the stapes wire is there. Where do I go from here?
I had a piece of metal (with plastic tubing around it) in 1977, by Dr. Edmonds in Toronto, Ontario. There is no records anywhere of that surgery. I have tried to find out what type of metal was used. I have no pain, but I have had emotional problems (mood swings, depression) since teen years, and now wonder if this may be the cause?
Hi Mishe:
I fail to see how having a stapedectomy in 1977 could be causing your mood swings and depression. Why do you think there may be a connection?
Cordially,
Neil
Supposed to have an MRI on my spine/back. Had two stapedectomy’s done. One in 2001 and the other ear in 2004. I contacted surgeon’s office and was told they used a titanium Robinson Bucket prosthesis in both ears. After hearing some of these posts, I’m alarmed to even have it. Was having the MRI to check for possible herniated disc–now I’m wondering if they can do a CAT scan instead?
Hi BDG:
Since they used titanium prostheses in your ears, you shouldn’t have any problem with a MRI. According to one doctor, earlier Robinson Bucket prostheses were made of stainless steel, but yours was made later–and if yours is definitely made of titanium, that is a different matter and you should be ok.
Cordially,
Neil
I had my stapedectomys In 1969 and 1978. By contacting records at the hospitals the surgeries were done I was able to get copies of the operative records that had what was used. It may have been easier for me as I still had the bills from the surgeries. 1969 surgery used gelfoam wire and the 1978 surgery was 4.25 piston platinum. Now that I have this info I need to research if I can have an MRI.
Hi Barb:
The gelfoam wire seems to be ok in MRIs up to 1.5 Tesla according to this article at https://www.sciencedirect.com/science/article/pii/0730725X87901305
Since platinum is not magnetic, it should be ok too.
Cordially,
Neil
I had a stapedectomy in 2017 and they used a Smart 360 Stapes piston, and notes that it is nitinol fluoroplastic on the card they gave me. The card also indicates that I am safe for an MRI with a “static magnetic field of 3-Tesla or less, spatial gradient field of 720-gauss/cm or less”. I am due for an annual MRI for breast health (due to high risk for breast cancer). Am I okay to get an MRI? This site has me concerned
Hi Heather:
From what you say, it sounds like you are ok to have an MRI. But don’t take my word for it. Take your card to the MRI place ahead of time and let them make the decision. They may need time to phone the manufacturer to be sure.
The nitinol is made up of nickel and titanium–the NI and TI in the name respectively. Titanium is not magnetic so it is a safe metal for an MRI, but nickel is magnetic so that is why you need to check, but it seems the manufacturer indicates its ok.
Cordially,
Neil
Helllo, I had Stapes surgery between 1986-1991 at Northwestern Memorial Hospital by a doctor named Wylie Harrison. The hosp does not have my records, but I need to identify the type of metal that was used. Can you help??
Hi Wendy:
I had the same issue a few years ago with info regarding a stapes implanted by Dr. Derlacki in 1972, who I believe was your Dr’s office partner. A record request was not successful. I did some on-line searching, and found a 2007 medical article by Dr. Michael Fritsch “MRI Scanners and the Stapes Prosthesis” and other articles and guidelines. I found the Fritsch article to be worth careful reading. I eventually underwent a 3T MRI of my lower torso without a problem.
I’ve had 2 stapes done, one in each ear… right ear is great ,I have about 88%hearing… but left ear is at about 8% …I can’t make out words in that ear… I hear some sounds and tones but a hearing aid will only make the noise louder.. is it possible that the prostetic moved in the healing process?
Hi Kathleen:
There are some possibilities. Yes, it could have moved/shifted if it wasn’t installed properly. It could have also pierced the oval window. I’d find out who is the best ENT for stapedectomies in your area and see what he thinks. He may be able to redo the surgery and fix things for you. In any case, you’ll have a better idea what is going on in that ear.
Cordially,
Neil
Hi Neil
I have a failed stapedectomy and am looking to have it fixed if possible. What’s the percentages of ENTs performing a second surgery. I also Googled and found out that Dr Cliff Megerian has invented a new prosthesis when heated fuses to the old bone or can totally replace it when heated on insertion. Have you heard of this new prosthesis and whether any other doctors in other countries are using it??
Cheers
Fay
Hi Fay:
I don’t know the percentages of ENTs that do second surgeries if the first one fails. I just assume that most do, but I don’t really have a clue.
Dr. Megerian’s invention is a cool idea. Basically all it is, is a new way of “gluing” the prosthesis to the incus bone using a metal “shrink-wrap” process.
However, this method won’t necessarily prevent stapedectomy prosthesis failures in the future if spongy bone grows around the prosthesis and “gums up the gear-works” again which is a reason this surgery fails for some people.
Cordially,
Neil
I had 3 stapedectomies done by Dr Ernest Butler in Austin Tx – left ear in 1979, right ear in 1981 and a redo of the right ear due to scar tissue disabling the first device in 1983. I have been wearing hearing aids for 15 years due to ongoing hearing loss.. They work very well.
Dr Butler died some time ago – no records that I can find. I have no idea of the type of material that the devices were made o around that time. I recently had a shoulder injury that needed an MRI before surgery..the clinic asked the “metal in your head or body” question & I mentioned having the 3 stapedectomies almost 40 yrs ago. They would not do the MRI.. Should I assume the material was metal at that time? Thank you
Hi Elizabeth:
The safer course of action when it doubt is to assume your implant had a magnetic metal in it. However, a lot of stapedectomies used titanium and it is non-magnetic so is safe for MRIs.
Since your doctor’s records are “missing”, try the hospitals where you had the stapedectomies done and see whether they have the appropriate records.
Cordially,
Neil
Hi, I had two stapedectomies performed in the early 90s. I know that the pistons were Teflon but don’t have the names or batch nos.. I am due to have an MRI within the next couple of weeks but not sure whether I should. Thank you
Hi Fliss:
Were you pistons made entirely of Teflon, or just Teflon coated? That is a big difference. You need to get your records from the place that did your stapedectomies and make sure there were no magnetic metals in your pistons–namely iron, steel, nickel or cobalt. If they used titanium, plastic or bone, you should be ok.
Cordially,
Neil
Had a stapedectomy in the early 70’s. over the last few years have had about 3 MRI. Asked about the in plant (stainless steel) which was checked out and the MRI went ahead with no negative results. Recently my doctor ordered an MRI. At the hospital this was x-rayed first then advised not to have the MRI as the machine had high level magnetism. There seems to be differing levels of magnetism which the earlier MRI’s had? I would be interested in comments
Hi Peter:
Different MRI machines can put out differing strengths of magnetic fields. The units of measurement are tesla. Most MRI’s only put out a 1.5 tesla field. Others put out double that, 3 tesla fields. Actually, some can put out as low as 0.2 tesla fields and high-powered MRIs used in research can put out 11 tesla.
The lower the field strength, the less “pull” on the stainless steel prosthesis so depending on the machine’s strength as to whether they will do an MRI on you. It also depends where the MRI is being done–on your head or lower leg for example.
Some hospitals may have different rules about giving an MRI to a person that has any magnetic metal (iron, steel, nickel, cobalt) in their bodies. Hence the variations you have experienced.
Newer prostheses are often made of titanium , which is not magnetic, so are safe to use with MRIs.
Cordially,
Neil
Hi Neil
I had a stapedectomy done back in 2005 and now I have a problem with that ear not being able to equalize and a full feeling like you’ve got off a flight all the time. I also sometimes get a vibrating feeling in my middle ear. What has happened to the procedure so you think? I have had head MRI’s but I have a plastic prosthesis.
Hi Fay:
Let me see if I have this right. You had the stapedectomy in 2005 and everything worked well for the past 17 or so years, but now things are going bad, correct?
What makes you thing the stapedectomy is the problem and not some other condition?
It is true that stapedectomies sometimes only work well for a few years and then have to be replaced, but the two symptoms you mention could be explained by other ear conditions. For example, if you are high-strung and anxious or particularly stressed, or accidentally exposed your ears to a sudden loud sound you could actually be experiencing tonic tensor tympani syndrome (TTTS). It could also be because your trigeminal nerve is either pinched in your neck (C5 vertebra) or has been hyperstimulated and is not calming down.
Cordially,
Neil