Ossicular Chain Reconstruction

What is Ossicular Chain Reconstruction?

There are many potential causes of conductive hearing loss. The sound conduction system in the middle ear consists of three small bones called ossicles. These bones can be damaged by recurrent ear infections, trauma or previous surgery. This condition results in a conductive hearing loss that can become severe over time. This condition can be diagnosed with an otolaryngology examination and hearing test.


Figure 1  Normal hearing mechanism


The hearing can be restored with a surgical procedure called ossicular chain reconstruction. Hearing aids can be helpful in patients who do not desire surgical treatment.

Ossicular chain reconstruction

Ossicular chain dysfunction can be corrected with a surgical procedure called ossicular chain reconstruction. The procedure is an outpatient surgery that takes 30 to 40 minutes. It is performed under local or general anesthesia. The surgery is typically performed through the ear canal.

How the Surgery Works

The non-functioning ossicle (bone) is removed and replaced with an artificial implant.


Figure 2  Displaced  incus bone (left ear).

Figure 3  Left middle ear implant to replace incus bone

Figure 4  Missing middle ear bone replaced with implant (right ear).

After Surgery Care

Antibiotic ear drops are used in the ear after surgery. Regular activities are started the next day. Patients are typically seen 3 weeks after surgery to ensure proper healing and a hearing test is performed after the healing process is completed.

How Long Does the Surgical Correction Last?

The hearing implant typically lasts for the life of the patient. In a small number of cases, the implant function may decrease over time. In these cases, revision surgery can often restore the hearing again.