Ossicular Chain Reconstruction

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Ossicular chain reconstruction is a type of middle ear bone surgery that can help to improve hearing in those who suffer conductive hearing loss.

Understanding ossicular chain reconstruction

Ossicular chain reconstruction is a procedure performed to restore hearing to those who suffer from conductive hearing loss caused by damage to one or more of the three middle ear bones.

During the procedure, the damaged bone(s) is removed or rebuilt using synthetic material. If the bone is removed, an implant is inserted its place.

How does the ossicular chain work?

The bones in the middle ear play an important role in the ability to hear. When sound enters the ear, it causes the eardrum and the ossicles (the three tiny middle ear bones) to vibrate. These vibrations are converted into electrical nerve impulses, which travel along the auditory nerve to the brain.

Damage to any of the three ossicles, the malleus, incus and stapes (sometimes also called the hammer, anvil and stirrup), disrupts the process, resulting in conductive hearing loss. Reasons for damage include:

  • Traumatic injury
  • Chronic Infection
  • Cholesteatoma (skin cyst that develops in the middle ear)

Ossicular chain reconstruction procedure  

Ossicular chain reconstruction is an outpatient procedure performed through the ear canal or an incision behind the ear. An incision is also made around the eardrum, allowing access to the middle ear bones. The damaged bone is then reconstructed using synthetic materials and repositioned or the bone may be removed and replaced with an implant.

After ossicular chain reconstruction

Most patients go home within a few hours of the procedure. A small amount of bloody or clear drainage from the ear may occur for a few days after surgery. It is important to protect the ear from water while healing. Showering may be permitted after a few days, as long as the ear is protected. Activities, such as nose blowing or air travel, that cause increased ear pressure should be avoided until approved.

Some patients experience a dizziness for a few days after ossicular chain reconstruction but it typically resolves within a few days. Antibiotic ear drops may be prescribed to prevent infection.

Hearing is not evaluated until a few weeks after surgery since full results may not be immediately evident.


Otolaryngology Surgeons

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