Ossicular Reconstruction in Chronic Ear Surgery

Abstract

The hearing results of 545 chronic ear operations after a median follow-up period of three years are reported. Results were related to the reconstruction methods with autograft or homograft ossicles vs two- or three-legged stainless steel wire in conditions where the posterior ear canal wall or the middle ear mucosa or both were left in place or removed. The best results were obtained in the group with intact ear canal wall and preserved middle ear mucosa. The main cause of failures to improve hearing permanently was malfunction of the Eustachian tube. Adhesive middle ears sometimes developed many years after an initially successful operation. Reconstruction by means of the ossicles is preferred to stainless steel wire. The latter is useful especially when the oval window niche is narrow and when the foot plate only remains.