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March 1960

Ossicular Repositioning and Ossicular Prostheses in Tympanoplasty

Author Affiliations

Tampa, Fla

AMA Arch Otolaryngol. 1960;71(3):443-449. doi:10.1001/archotol.1960.03770030085017

In tympanoplasty, ossicular repositioning and ossicular prostheses offer an opportunity to preserve the air space of the middle ear and improve the transmission of sound to the stapedial footplate. Depending upon the pathological circumstances, any convenient remaining portion of the auditory ossicles may be used to reconstruct a functioning ossicular chain. My interest in ossicular repositioning (transposition) developed following disappointment in the restoration of hearing by use of tympanoplasty Type IV (hypotympanoplasty) when the crura of the stapes had been destroyed. Therefore, I began to reconstruct stapedial crura using the incus, the head of the malleus, the long process of the malleus, the handle of the malleus, or a fragment of cancellous bone from the mastoid tip. This ossicular recruralization of the stapedial footplate converts a Type IV into a Type III, and some surgeons classify this as a Tympanoplasty Type III-B. As in all tympanoplastic surgery, I prefer to