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Ossicular Chain Reconstruction: 1 or 2 Bones

Ossicular chain reconstruction can improve conductive hearing. It is also called middle ear bone surgery. 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 have general anesthesia. Middle ear bone surgery takes about 1 to 3 hours. It is often done along with a tympanoplasty or a mastoidectomy.

Man's face showing middle ear structures.

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 your surgeon may make an incision behind the ear. Your surgeon then makes an incision around the eardrum. The eardrum is held to one side. Your surgeon takes out all or part of the damaged bone.

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

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

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