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Ossicular Chain Reconstruction: One or Two Bones

Man's face showing middle ear structures.

Ossicular chain reconstruction (also called middle ear bone surgery) can improve conductive hearing. It can be done to replace a damaged malleus or incus bone. During surgery, you will be given local anesthesia with sedation. Or you may receive general anesthesia. Middle ear bone surgery takes about 1 hour to 3 hours. It is often done along with a tympanoplasty or a mastoidectomy.

Cross section of ear showing outer, inner, and middle ear structures with damaged incus.

Damaged malleus or incus bones

Injury or infection can damage the malleus or incus bones. Your surgeon reaches these bones by going through the ear canal or making an incision behind the ear. Then an incision is made around the eardrum. The eardrum is held to 1 side. All or part of the damaged bone is removed.

Cross section of ear showing outer, inner, and middle ear structures with prosthesis replacing incus.

Replacing one or both bones

The damaged malleus or incus bone — or both — may be rebuilt with synthetic material. Or it may be replaced with a manmade part. This part is called a prosthesis. Your surgeon attaches the prosthesis where needed. Then the eardrum is put back in place.


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