Ossiculoplasty

Graphic courtesy of EON MEDITECH
PVT. LTD. with permission

Indication

To reconstruct the ossicles within the middle ear (malleus, incus, stapes - see right diagram). These types of patients have a type of hearing loss known as conductive hearing loss.

Procedure

This operation is often also performed at the same time as a tympanoplasty. It can also be performed on its own. If it is done during a tympanoplasty, the ossicles are examined and the reconstruction is performed either with reshaping/reposition of the patient's existing bones or using prosthetic bones (TORP: total ossicular replacement prosthesis or PORP: partial ossicular replacement prosthesis; e.g. of PORP is right diagram). If the operation is done on its own, the approach to the middle ear is the same as a tympanoplasty, either going through the ear canal via a small superior incision (endaural) or behind the ear (post-auricular). The surgeon then lifts up the intact ear drum to enter the middle ear.

Statistics

Over 200 ossiculoplasties are performed annually at Sunnybrook Health Sciences Centre.

Post-operational care

For patients undergoing a post-auricular approach, the incision behind the ear closed using staples. These will be removed in our office usually 10-14 days after surgery. Those undergoing an endaural approach will have 2-3 dissolvable sutures on the incision. Both types of incisions can be cared for by applying Polysporin® twice a day over the incision.

For the vast majority of ossiculoplasties, the packing in the external ear is usually soaked with blood from the operation. This is completely normal. It is also common for some blood coloured drainage to discharge from the external ear for several days after surgery. If there is concern about the colour or rate of discharge, please contact your surgeon's office.

DO NOT touch or remove the packing in the ear canal. Please try to keep your ear dry at all times until proper healing or the time frame given to you by your surgeon. To minimize stress on the operation site, do not lift weights greater than 25 lbs. for 4-6 weeks after the surgery. You are also to avoid flying for 4-6 weeks. Also, coughing, straining, sneezing, and blowing your nose should be done as little as possible; if you must cough or sneeze do so with your mouth open as wide as possible to minimize the pressure. Any significantly extra pressure can potentially dislodge the prosthesis which will reduce the rate of success. Most people who perform little physical activities at work can resume work in approximately 1 week.