Abstract
Introduction CONDUCTIVE deafness caused by OSsicular chain lesions can be of two main types: (1) fixation of ligaments, joints, and tendons as seen in otosclerosis 1 and tympanosclerosis 2 ; (2) destruction of whole or part of one or more ossicles as seen following chronic otitis media, 3 cholesteatoma, or trauma. 4 In this last group it is the incus which is probably mostly affected (Fig 1), as a result of the precarious blood supply of its long process, 5,6 and will bring about important hearing loss due to ossicular chain interruption. Originally, such isolated lesions were treated by performing a tympanoplasty type 3. 7,8 With the experience gained in the last decade in reconstructive middle ear surgery it was found more useful to leave the middle ear as near as possible to its original functional form and size and avoid a smaller tympanic cavity which was by necessity formed in
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