Hearing Aids Hearing Loss Pediatric Hearing Loss Tinnitus Surgical and Implantable Hearing Correction

ossicular chain reconstruction Case Number 1

This patient had undergone significant TMJ surgery. During the surgery, she sustained damage to her ear canal and eardrum, with resultant perforation of the eardrum and conductive hearing loss. She was found to have damage to the 2nd and 3rd hearing bones, the incus and the stapes. These were reconstructed and her eardrum repaired.

1) A wispy perforation of the eardrum is seen.
2) The eardrum is elevated and the middle ear is explored.  The arrow signifies the footplate, which is the mobile barrier between the inner ear and the middle ear.  Typically, the stapes, or 3rd hearing bone, sits on top of this footplate and vibrates the the fluid of the inner ear to create hearing.  In this ear, there is no connection between the eardrum and the inner ear because the hearing bones are completely missing from the previous damage she sustained.
3) This is a titanium shoe that will sit on the footplate and will accept the prosthesis into it.
4) This is a titanium and hydroxyapatite prosthesis that will connect the eardrum to the inner ear.  The length of this prosthesis is about 5 mm.  This prosthesis will fit into the footplate shoe (previous image) and allow vibration of the footplate and inner ear fluid so that hearing can occur.
5) The prosthesis is placed into the middle ear to allow hearing.  The titanium footplate shoe (black arrow) sits on top of the footplate.  The hearing prosthesis bridges the gap between the eardrum and the inner ear (blue arrow). A cartilage graft (white arrow) is placed on top of the prosthesis to stabilize it in the middle ear and to prevent it from extruding through the eardrum.
6) The eardrum perforation is repaired (black arrow) and the ear canal is packed with dissolvable packing to allow healing.  Her hearing is immediately improved with this procedure.

Hearing Reconstruction Procedure Cases

Dallas Ear Insittute

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