ossikuloplastiaa

Ossikuloplastiaa, known in English as ossiculoplasty, is a surgical procedure to repair or reconstruct the small bones of the middle ear—the malleus, incus, and stapes—to restore conductive hearing loss. It is indicated when the ossicular chain is disrupted or eroded due to chronic otitis media, cholesteatoma, trauma, otosclerosis, or other inflammatory diseases. The aim is to restore continuity of the ossicular chain or to replace missing segments so that sound transmission to the inner ear is improved.

The procedure is typically performed in conjunction with tympanoplasty or mastoidectomy and is carried out under general anesthesia through a canal wall or postauricular approach. Techniques use autografts, such as reshaped patient’s own ossicles or cartilage grafts, and alloplastic prostheses. Autografts can help bridge gaps when native bones are damaged, while prosthetic implants provide a stable connection between remaining middle ear structures and the inner ear.

Prosthetic categories include partial ossicular replacement prosthesis (PORP), which connects the tympanic membrane or malleus to the stapes head, and total ossicular replacement prosthesis (TORP), which replaces the incus and stapes and connects between the tympanic membrane/malleus and the stapes footplate or vestibule. Prostheses are commonly made from biocompatible materials such as titanium or other suitable implants.

Outcomes vary with the condition of the middle ear and tympanic membrane. Many patients experience improved air-conduction hearing, but results depend on disease control and reconstruction success. Complications can include prosthesis extrusion or displacement, infection, persistent conductive loss, or rarely sensorineural deterioration. Ossikuloplastiaa is considered when middle-ear pathology is manageable and medical treatment alone has not resolved the conductive deficit.