Musculoplasty is a standardized operation for the restoration of hearing in deafness resulting from chronic otitis. Since it is an operation for deafness, it was never meant to be used where the ossicular chain is still intact and the patient has reasonably good hearing. In these cases, of course, one preserves the natural system of sound conduction and repairs the minor defects. Musculoplasty is intended to be used where the ossicular chain has been destroyed. In these ears there are major pathological defects and usually long-standing and well-established disease in the mastoid as well as in the middle ear, and it is not logical to attempt to repair or build on the existing structures. To do so carries with it the danger of burying sepsis or epithelium.
To reconstruct these ears so that permanent hearing will be restored the surgery must accomplish the following three things: (1) All disease must