What is ossicular chain reconstruction surgery?
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.
What is the procedure for ossiculoplasty?
The procedure for ossiculoplasty (which is an ear surgery in Seattle WA) takes place under general anesthesia or IV sedation administered by our MD Anesthesiologist and takes approximately one to two hours. This is done either by itself or in conjunction with other procedures including mastoidectomy and ossicular chain reconstruction.
What is tympanoplasty with ossicular chain reconstruction?
Tympanoplasty with Ossicular Chain Reconstruction Three small bones connect the eardrum to the inner ear. Hearing loss occurs if there is a problem with these bones and/or the ear drum. In most cases, an implant can reconnect the bones and improve hearing (ossicular chain reconstruction).
What are the two types of ossicular reconstruction?
ossicular reconstruction ossicularly ossicularly ossiculate ossiculate ossiculate Ossiculated ossiculately ossiculectomy ossiculotomy ossiculum
How is ossicular chain reconstruction done?
The eardrum, or tympanic membrane, is carefully elevated from the surrounding canal, and the ossicles are carefully examined and palpated. If the ossicles appear to be in good condition, one of the ossicles is removed, sculpted into proper shape, and repositioned to reestablish an intact ossicular chain.
How long does ossicular chain reconstruction last?
Ossicular Chain Reconstruction: 1 or 2 Bones 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.
Is ossicular chain reconstruction painful?
Patients report little pain after surgery, and it takes about six to eight weeks until you experience improved hearing. There are several post-operation instructions, so be sure to have a detailed discussion with your surgeon about how to care for your ear after surgery.
How successful is ossicular chain reconstruction?
Surgical reconstruction of the ossicular chain is a well-established procedure for repair of ossicular defects, but is still plagued by high failure rates, with success rates in closing the air-bone gap to less than 20 dB ranging generally from 55%–75% [1–8].
Can you replace ossicles?
Ossicular chain reconstruction (also called middle ear bone surgery) can improve conductive hearing. It can be done to replace a damaged malleus or incus bone. During surgery, you will be given local anesthesia with sedation.
How do you shower after ear surgery?
ShoweringALWAYS keep the inside of the ear dry.Shower or bathe 48 hours after surgery, but do not soak or scrub the wound.Place a cotton ball coated with Vaseline or an earplug in the outside bowl of the ear (don't use cotton without lubricant or push on packing inside the ear)More items...
What will happen if ear ossicles are removed from the middle ear?
Disruption of the ossicular bones will lead to significant hearing loss. Although an interruption of the ossicles will not cause complete deafness, the hearing loss can be quite substantial.
Where is the ossicular chain located?
the middle earThe ossicles are situated in the middle ear and suspended by ligaments. They articulate with each other through synovial joints to form a chain across the length of the middle ear from the tympanic membrane (laterally) to the oval window (medially).
Can middle ear bones be replaced?
During an outpatient procedure known as an ossicular chain reconstruction, the non-functioning middle ear bone is removed and replaced with an artificial implant.
How painful is a tympanoplasty?
You may get mild, intermittent ear pain during the first 2 weeks after surgery and that is OK. The pain that can be fleeting or stabbing in nature is felt above or in front of the ear and increases while chewing. Your doctor will prescribe you a pain medication, which you may take for several days after surgery.
How long does Ossiculoplasty surgery take?
The surgery can take one to two hours. The operation will sometimes require a small cut just in front of the ear or behind the ear or sometimes no cut at all. Your surgeon will discuss with you how your operation will be done.
How do you treat ossicular discontinuity?
Ossiculoplasty, or ossicular chain reconstruction, is a procedure used to treat ossicular chain discontinuity. This condition most often happens when chronic ear infections destroy middle ear bones.
How long does Ossiculoplasty surgery take?
The surgery can take one to two hours. The operation will sometimes require a small cut just in front of the ear or behind the ear or sometimes no cut at all. Your surgeon will discuss with you how your operation will be done.
What happens if the ossicles is damaged?
Three tiny bones in your middle ear carry sounds to the inner ear. If these bones are damaged or malformed, you may experience a condition called ossicular chain discontinuity. This condition can lead to gradual hearing loss and a ringing, buzzing or roaring sound in your ear called tinnitus.
What is middle ear reconstruction surgery?
An effective ossiculoplasty with autografts or synthetic materials improves the patients overall hearing restoring a stable connection between the tympanic membrane and the inner ear.
How painful is a tympanoplasty?
You may get mild, intermittent ear pain during the first 2 weeks after surgery and that is OK. The pain that can be fleeting or stabbing in nature is felt above or in front of the ear and increases while chewing. Your doctor will prescribe you a pain medication, which you may take for several days after surgery.
What is Ossiculoplasty?
The procedure for ossiculoplasty (which is an ear surgery in Seattle WA) takes place under general anesthesia or IV sedation administered by our MD Anesthesiologist and takes approximately one to two hours. This is done either by itself or in conjunction with other procedures including mastoidectomy and ossicular chain reconstruction. An incision is made behind the ear to access the ear canal. The eardrum, or tympanic membrane, is carefully elevated from the surrounding canal, and the ossicles are carefully examined and palpated. If the ossicles appear to be in good condition, one of the ossicles is removed, sculpted into proper shape, and repositioned to reestablish an intact ossicular chain. If this is not possible, a synthetic prosthesis is used to reestablish the ossicular chain. The prosthesis or resculpted ossicle is held in place by a supporting layer of absorbable gelatin sponges placed in the middle ear. The tympanic membrane is then placed back into its proper position. The incision behind the ear is then sutured closed. We perform this ear Surgery procedure in Seattle WA. We also perform a variety of other ear procedures at our practice such as Stapedectomy.
How long does it take for ear surgery to heal?
Do not be concerned regarding your hearing during the healing process. It takes 6 – 8 weeks before we can evaluate improvement and your hearing will be tested at that time.* Bloody or watery drainage from the incision area may occur during the first 7 – 10 days. If this happens tape a piece of gauze over the area. Call the office if this persists longer than 10 days or if it develops an odor, swelling, or pain. Water should be kept out of the ear until it is healed. You may take a shower 2 days after the surgery provided you cover the ear with a cotton plug soaked in ointment and a shower cap to cover your head. The hair may be shampooed separately outside of the shower 3 days after surgery providing water is not allowed to enter the ear canal. Frequently there is a period of unsteadiness following surgery. This usually resolves within a few days. It is extremely rare for dizziness to persist. Ringing in the operated ear usually improves with surgery; rarely it may become worse during the postoperative period. Do not blow your nose with force for 2 weeks. If you sneeze, do so with your mouth open. Ear drops should be used as prescribed. No bending, lifting, straining aerobic exercise, heavy work or traveling until approved by your surgeon. DO NOT USE ASPIRIN OR IBUPROFEN PRODUCTS FOR 2 WEEKS POST-OP. No flying for 6 (six) weeks post operatively.
What is an incision made behind the ear?
An incision is made behind the ear to access the ear canal. The eardrum, or tympanic membrane, is carefully elevated from the surrounding canal, and the ossicles are carefully examined and palpated. If the ossicles appear to be in good condition, one of the ossicles is removed, sculpted into proper shape, and repositioned to reestablish an intact ...
How is a synthetic prosthesis used?
If this is not possible, a synthetic prosthesis is used to reestablish the ossicular chain. The prosthesis or resculpted ossicle is held in place by a supporting layer of absorbable gelatin sponges placed in the middle ear. The tympanic membrane is then placed back into its proper position.
How good is hearing after ossicular reconstruction?
When discussing outcomes with patients, it is important to provide a realistic expectation of hearing results. Successful hearing results in ossicular reconstruction are based on the postoperative air-bone gap and stratified as excellent (<10 dB), good (11 to 20 dB), and fair (21 to 30 dB). This success also depends on several factors including the presence or absence of a mobile stapes superstructure, intact canal wall with normal middle ear volume, and adequate eustachian tube function. Although outcomes vary slightly depending on the type of prosthesis used, successful improvement in hearing is generally broken down according to the use of a PORP versus a TORP. In patients undergoing ossicular reconstruction with a PORP, two thirds of patients should achieve hearing outcomes within 15 dB of their bone scores, whereas two thirds of patients with a TORP should achieve hearing outcomes within 25 dB of their bone scores. The disparity in outcomes between PORPs and TORPs is apparent in Brackmann and Sheehy’s review of 1042 cases in which successful hearing with an air-bone gap less than 15 dB was achieved in 63% of PORPs and only 42% of TORPs. 23 Regardless of the technique or type of prosthesis, surgeons should use what they are most comfortable with and provides consistent good hearing results.
What material is used for autografts?
The most commonly used autograft material was the body of the incus; however, cartilage and cortical bone were also used. These natural materials were well tolerated in the middle ear and provided reliable hearing results. The disadvantages that soon became apparent were the prolonged time required to sculpt the prosthesis and the lack of availability in chronically diseased ears. In an effort to circumvent some of these issues, in 1966, House and colleagues 9 first reported the use of homografts in middle ear reconstruction. Other reports soon followed describing the use of irradiated ossicles, cartilage, and even homograft tympanic membranes with en bloc ossicles. 10,11 Homografts had hearing results and biocompatibility similar to autografts; however, concerns regarding the risk of transmission of human immunodeficiency virus and prions (i.e., Creutzfeldt-Jakob disease) ultimately led to their decline in use.
Can ossicular chain reconstruction be done?
The selection of patients undergoing ossicular chain reconstruction largely depends on the problem at hand. Any patient with chronic otitis media may ultimately be a candidate for ossicular chain reconstruction. These patients often present because of the hearing loss associated with their infection or chronic middle ear disease. In other cases, initial hearing may be normal, but become compromised secondary to surgery to remove cholesteatoma. Still other patients present with hearing loss resulting from ossicular problems associated with trauma or congenital ear malformations. Regardless of the cause, the initial evaluation requires a thorough microscopic examination of the ear to identify the problem accurately.
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.
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.
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Treatments
The hearing can be restored with a surgical procedure called ossicular chain reconstruction. Hearing aids can be helpful in patients who do not desire surgical treatment.
How The Surgery Works
The non-functioning ossicle (bone) is removed and replaced with an artificial implant.
After Care Post-Op Care
Antibiotic ear drops are used in the ear after surgery. Regular activities are started the next day. Patients are typically seen 3 weeks after surgery to ensure proper healing and a hearing test is performed after the healing process is completed.
How Long Does the Surgical Correction Last?
The hearing implant typically lasts for the life of the patient. In a small number of cases, the implant function may decrease over time. In these cases, revision surgery can often restore the hearing again.
How long does it take to re-injure the eardrum?
The procedure is performed by making small incisions in the ear canal or just behind the ear. It leaves no visible scars. Surgery takes approximately one hour , with most patients ready to leave 3 hours after arrival.
What is a tympanoplasty?
Tympanoplasty with Ossicular Chain Reconstruction. Three small bones connect the eardrum to the inner ear. Hearing loss occurs if there is a problem with these bones and/or the ear drum. In most cases, an implant can reconnect the bones and improve hearing (ossicular chain reconstruction).
