The ossicles are susceptible to damage or destruction from a number of sources, such as infection, trauma or disease e.g. cholesteatoma. When this damage occurs their function is disrupted resulting in a hearing loss.
An ossiculoplasty is a procedure that is designed to rebuild, reshape or replace the ossicles (often with a prosthesis) in an attempt to restore the function of the middle ear.
There are two approaches to the operation; either endoscopic or via an incision.
Risk of general anaesthetic, pain, bleeding, infection, dizziness (vertigo), change in taste(damage to corda tympani), facial palsy (damage to facial nerve - temporary or permanent), CSF leak, damage to hearing (dead ear),
The images to the right show a titanium prosthesis sitting on the stapes. The ear drum has been lifted to show the anatomy and the stapes clearly.
The second of these images has a cartilage graft sitting on the prosthesis to prevent the tympanic membrane from being damaged.
In this patient, the incus was destroyed by cholesteatoma and so there was no contact between the remaining ossicles and tympanic membrane.
The prosthesis improved contact with the drum and hearing improved.