Ossiculoplasty
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2025-03-08
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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery
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University of Cape Town
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Abstract
Ossiculoplasty is defined as restoring the hearing mechanism between the tympanic membrane and the oval window by reestablishing a functioning ossicular chain. It is indicated for ossicular discontinuity following erosion, trauma or ossicular fixation due to tympanosclerosis, adhesions etc. Operating on an only hearing ear is an absolute contraindication for ossiculoplasty. Chronic otitis media may also cause ossicular disruption due to erosion of the ossicular chain. Ugo Fisch classified ossicular defects seen in chronic otitis media in accordance with the expected functional hearing outcomes (Table 1). Patient selection is based on the preoperative audiogram AND the potential to regain serviceable hearing. A patient will benefit if the hearing level of the poorer hearing ear is raised to within 15dB of the bet-ter hearing ear. Second stage ossiculoplasty is usually less invasive and can be done by an endaural approach. One can anticipate the likely course of the ossiculoplasty from otoscopy and audiogram findings.
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Reference:
Harris, T. & Linder, T. 2025. Ossiculoplasty. In Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. J. Fagan, Ed.Cape Town, South Africa: University of Cape Town. 9. http://hdl.handle.net/11427/43531 .