Ossicular chain discontinuity, or separation of the middle ear bones, most commonly happens when chronic ear infections dissolve the delicate middle ear bones. A hearing aid is almost always helpful and no further treatment is needed. However, in many cases surgery is also an option. In an operation called an ossicular chain reconstruction, or ossiculoplasty, the surgeon bypasses the diseased bone with a prosthetic device that allows sound waves to be passed to the inner ear.
The success rate of ossicular chain reconstruction to improve hearing depends on the problem. If the stapes is intact, the rate of a good hearing result is about 75 percent. If the stapes is not intact, the rate of a good hearing result is about 50 percent. For some other situations, the rate of a good hearing result is close to 90 percent.
Although the surgeon always tries to repair the problem, the healing process has a major impact on the ultimate hearing outcome. Scar tissue can pull on the delicate ossicles and/or ossicular prosthesis, moving them from the best position. If the hearing result is less than expected, surgery can often be done again to try to make it better.
The outpatient surgery usually can be performed under local or general anesthesia and is typically done in the operating room of a hospital. Hearing is usually regained quickly.