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Ossiculoplasty in India

What is Ossiculoplasty ?

In both of these situations, it is possible to improve hearing by removing the stapes bone and replacing it with a micro prosthesis - a stapedectomy, or creating a small hole in the fixed stapes footplace and inserting a tiny, piston-like prosthesis - a stapedotomy. The results of this surgery are generally most reliable in patients whose stapes has lost mobility because of otosclerosis. Nine out of ten patients who undergo the procedure will come out with significantly improved hearing while less than 1% will experience worsened hearing ability or deafness. Successful surgery usually provides an increase in hearing ability of about 20 dB. That is as much difference as having your hands over both ears, or not. However, most of the published results of success fall within the speech frequency of 500 Hz, 1000 Hz and 2000 Hz; poorer results are typically obtained in the high frequencies, but these are normally less hampered by otosclerosis in the first place.

Classification
  • Type 1 involves repair of the tympanic membrane alone, when the middle ear is normal. A type 1 tympanoplasty is synonymous to myringoplasty.
  • Type 2 involves repair of the tympanic membrane and middle ear in spite of slight defects in the middle ear ossicles.
  • Type 3 involves removal of ossicles and epitympanum when there are large defects of the malleus and incus. The tympanic membrane is repaired and directly connected to the head of the stapes.
  • Type 4 describes a repair when the stapes foot plate is movable, but the crura are missing. The resulting middle ear will only consist of the Eustachian tube and hypotympanum.
  • Ossiculoplasty


    Surgical Approach

    Tympanoplasty can be performed through the ear canal (trascanal approach), through an incision in the ear (endaural approach) or through an incision behind the ear (postauricular approach).

    A graft may be taken to reconstruct the tympanic membrane. Common graft sites include the temporalis fascia and the tragus.

    The surgery takes ½ to 1 hour if done through the ear canal and 2⅓ to 3 hours if an incision is needed. It is done under local or general anesthesia. It is done on an inpatient or day case basis and is successful 85-90% of the time.

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