Reconstruction of the Ossicular Chain

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Abstract
THE EVOLUTION of improved diagnostic examinations and surgical techniques has thus far failed to enable otologists to predict the degree of hearing gain resulting from tympanoplasty with accuracy approaching that now possible with regard to stapedectomy. The experiments to be reported here extend our previous attempts 1 to detect some of the causes underlying the variability of results in tympanoplasty and, when possible, to suggest alternatives which, at least on an experimental level, appear to solve particular problems. Specifically, we have investigated some of the anatomical and mechanical factors which appear to influence the transmission of sound through the middle ear when a defective ossicular system has been reconstructed with various types of prostheses. Whereas our former studies dealt with defects of incus alone, this work concerns experimental defects of the arcade of stapes alone or in combination with incus defects. Clinical application of certain principles already derived from these

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