Revision Ossiculoplasty: Indications and Techniques

PROGRAM DESCRIPTION: The success of ossiculoplasty depends on reconstruction techniques, prosthesis qualities, and middle ear disease severity, with the latter being most important. Unfortunately, not all ossiculoplasties are successful and revision surgery is indicated. Our experience based on over 2000 revision ossiculoplasties will demonstrate common patterns of failure based on the Wüllstein classification, and surgical techniques used to correct these maladies. Emphasis will be placed on anatomical consistencies, stabilization of the prosthesis at the level of the footplate, and cartilage reconstruction using the mosaic technique to prevent extrusion and recurrent disease. In addition, several options for reconstruction based on the chain defect will be discussed, and surgical selection, based on the middle ear severity index will be emphasized. Finally, we will discuss how to determine when revision is indicated.

This is an instructional course utilizing original pictures, artist’s drawings, and surgical videos in a PowerPoint presentation to outline techniques in revision ossiculoplasty, including decision-making based on the middle ear environment and examples of patterns of failure. This course will emphasize standardized techniques in ossiculoplasty based on ossicular defect and middle ear environment and will analyze postoperative results and decision-making based on audiometric findings and middle ear environment.