Experience-driven ossiculoplasty

This article reviews the causes of ossicular impairment, interpretations of chronic ear disease, and provides a structured approach to the surgical correction of conductive hearing loss. It discusses reasons for inadequate air bone gap closure following ossicular chain reconstruction. The article reviews the Austin-Kartush classification of ossicular impairment, which allows for classification of nearly any defect in the ossicular chain. Using the Austin-Kartush classification, our most common ossicular chain reconstruction techniques are presented. Alternatives to ossicular chain reconstruct are discussed. A surgical video of transcanal Vibroplasty is included and available for viewing online.