Introduction:

Ossiculoplasty is the reconstruction of the middle ear ossicular chain which has been disrupted or destroyed, by the use of interpositioned implants which help in regaining the original mechanics of the ossicular chain to transfer the sound energy to the inner ear. Ossicular abnormalities can range from loss of ossicular continuity due to trauma, congenital,surgical manipulation or middle ear pathology such as cholesteatoma or fixation of the ossicles in cases of otosclerosis or it can be in combination.

Why should I have an ossiculoplasty?

By reconstructing the hearing bones with artificial bones made out of titanium, plastic or cartilage your hearing can be improved. How much your hearing will improve is dependent on how severe the damage has been to the ear bones and middle ear and what type of artificial material we are able to use to repair the damage.

What are the risks?

• In some cases, after surgery the hearing may only slightly improve and you may still feel the operated ear hearing is still poor, even if we can see an improvement on a hearing test.
• It is normal to get a few days of dizziness and in some cases this can last more than a week.
• There is a small chance of tinnitus (noise in the ear). If you already have tinnitus it often gets better, although sometimes the tinnitus will stay the same, but it rarely gets worse.
• Some people experience a change in their taste at the front of the tongue on the same side as the operated ear. This is because the taste nerve runs underneath your eardrum and can become stretched or damaged during the operation.
• Sometimes you can get an infection in the operated ear which may affect the outcome of the hearing afterwards.
• There is a very rare chance that your hearing could completely disappear. In this situation not even a hearing aid would allow you to hear using that ear
• The facial nerve, which is responsible for movement of the facial muscles, runs very close to the area of surgery. There have been reports of this nerve being damaged during surgery, but this is very rare.

Are there any alternatives?

You do not have to have surgery to be able to improve your hearing. You can alternatively use a hearing aid and in some cases people manage without any additional hearing support.

How can I prepare for an ossiculoplasty?

• You will need to have had a hearing test three months before your operation. If you think you need another hearing test prior to the surgery, please contact the Admissions team.
• Arrange two weeks off work (if you require a sickness certificate please ask the nurse on the day of your surgery).
• Arrange for someone to come and pick you up after the surgery. This is because you cannot drive for 24 hours after a general anaesthetic.
• Bring all the medication you are currently taking with you on the day of your surgery
• Make you sure you have pain killers at home such as paracetamol and ibuprofen (unless you GP has told you can’t take these drugs).
• Inform the hospital if you have a cold, flu or tonsillitis in the two weeks before admission as your operation may need to be postponed.

What happens during an ossiculoplasty?

Please remember that your surgeon will confirm how your surgery is performed and will finalise your aftercare plan with you, as practices sometimes vary slightly. The below is a general guide.

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.

A protective antiseptic gauze or sponge is placed in the ear at the end of the operation to protect the ear whilst the healing starts. If a cut has been made in front of the ear this is closed with sutures that dissolve.