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Ossicular chain reconstruction (also called middle ear bone surgery) can improve conductive hearing. It can be done to replace a damaged malleus or incus bone. During surgery, you will be given local anesthesia with sedation. Or you may receive general anesthesia. Middle ear bone surgery takes about 1–3 hours. It is often done along with a tympanoplasty or a mastoidectomy.
Injury or infection can damage the malleus or incus bones. Your surgeon reaches these bones by going through the ear canal or making an incision behind the ear. Then an incision is made around the eardrum. The eardrum is held to one side. All or part of the damaged bone is removed.
The damaged malleus or incus bone—or both—may be replaced with a manmade part. This part is called a prosthesis. Or your surgeon may use a donor middle ear bone. Your surgeon attaches the prosthesis or the donor bone where needed. Then the eardrum is put back in place.