ABSTRACT
This chapter describes the common diseases that affect the ossicular chain, methods by which ossicular dysfunction occurs and the techniques by which ossicular function can be restored. The ossicular chain consists of three ossicles: the malleus, incus and stapes. These articulate with each other via diarthrodial joints. Chronic otitis media and recurrent acute otitis media are the commonest causes of ossicular disease. These may result in fixation, through fibrosis or tympanosclerotic deposition, or erosion of the ossicular chain. Erosion of the ossicular chain most often occurs at the long process of the incus or the stapes superstructure, as these have a poorer blood supply than other areas of the ossicular chain. The need for treatment is determined by the severity of the hearing loss, the attitude of the patient to the different available interventions, the likely aetiology of the ossicular dysfunction, the status of the opposite ear and the preferences of the treating surgeon.
