Continuous infections can slowly dissolve one or all three of the bones that make up the ossicles.
Genetics:
Babies are sometimes born with malformed ossicles. They can be repaired or replaced by having an operation called an ossiculoplasty.
Surgical Procedures
for Ossicular Chain Disruption (Ossiculoplasty)
As with mastoid surgery, an incision is
made behind the ear and a flap of skin
pulled back to access the inner ear chamber.
Photo Courtesy of The Internet Journal of
Otorhinolaryngology
One of more of the damaged ossicles is
removed and matched against various sized
artificial bones to get a close match.
Titanium is often used to replace one or
more of the bones and are custom fitted for
each patient’s unique bone lengths. Titanium
is used as the body will not reject the
metal and after time will actually grow a
slime covering over the metal. The ossicles are very small and this makes the surgery very delicate. This means that although the operation can improve
the hearing, it may not completely return.
Patients are put under local or general
anesthesia in a hospital and the implant procedure
usually lasts about two hours. Because of the small
size of the bones (and replacements) and the small
workspace of the middle ear (about a 1" chamber),
surgery is performed using a special microscope.
After discharge the following hearing should
immediately improve, and normal activity can be
resumed within several days after the outpatient
procedure.
For more serious middle and inner ear operations,
that are performed under general surgery, robotic
machines such as the Da Vinci™ are slowly replacing
direct manual contact of the middle ear for all or
parts of ossiculoplasty and inner ear operations.
