• The ossicles are the bones of hearing in the middle ear. They are very effective at transmitting sound, so damage to them results in quite a large hearing loss.
  • The bones can be damaged by repeated infections or by head injury, or eaten away by a cholesteatoma (a cyst).
  • Ossiculoplasty is an operation to reconnect the bones of hearing. A cut is made inside the ear canal so the eardrum can be lifted for access. The gap between the damaged ossicles is bridged by a graft. Often, the original incus bone can be reshaped and reinserted as the graft, or the graft may be made of plastic or titanium, or other small pieces of bone or cartilage taken from your ear.
  • The reconstruction can be done alone or as part of a more complex operation such as mastoidectomy.
  • It may be necessary to stay in hospital overnight, but you will usually be able to go home the next day. A light gauze dressing is placed in the ear canal and is removed in the outpatients department after 1-2 weeks.
  • The graft does not always stick properly. However, 80% of patients find that their hearing improves, even if it does not return completely to normal.
  • There is a small risk that the graft may be rejected if artificial materials such as plastic or titanium are used. They are slowly expelled from the middle ear and eventually fall out, even after several years. If this happens, your hearing will get much worse again.