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Ossicular Chain Reconstruction: Three Bones

Ossicular chain reconstruction (also called middle ear bone surgery) can improve conductive hearing. In some cases, all three middle ear bones are replaced. During surgery, you will be given local anesthesia with sedation. Or you may receive 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.

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

Cross section of ear showing outer, inner, and middle ear structures with prosthesis and tissue graft.

Damaged malleus, incus, and stapes bones

All three middle ear bones may be damaged. Your surgeon reaches the 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 one side. All or part of the damaged bones are removed.

Replacing all three bones

All three bones may be replaced with a manmade part. This part is called a prosthesis. Your surgeon places one end of the prosthesis against the eardrum. The other end may touch the bone over the inner ear or be laid against a tissue graft. Then the eardrum is put back in place.

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