In simple words: This surgery repairs a hole in the eardrum and removes diseased bone behind the ear.The surgeon also rebuilds the tiny bones in the middle ear that help with hearing. This procedure may also involve fixing the ear canal.

This procedure involves a radical or complete reconstruction of the tympanic membrane (eardrum) to repair a perforation, along with removal of a portion or all of the mastoid bone.The ossicular chain is also reconstructed to improve conductive hearing.This may involve reconstructing the ear canal and other middle ear surgeries.A postauricular incision is made to access the mastoid. The mastoid cortex and air cells are removed. The surgeon enters the mastoid antrum and roughens the edges of the tympanic membrane perforation. A posterior canal flap is created, the eardrum is reflected forward, and any adhesions, debris, or cholesteatoma are removed from the middle ear. Portions of the canal wall are removed down to the facial nerve.All or part of the ossicles and middle ear mucosa are removed, and the ossicular chain is reconstructed, potentially using donor ossicles, a sculpted bone strut, or cartilage. The ear canal may be reconstructed if necessary. A fascial graft or other tissue is used to repair the eardrum, and packing may be placed for support.Silicone material may be inserted to create an air-containing space for sound conduction. The skin in the ear canal is repositioned and packed, and any external incisions are sutured closed.

Example 1: Chronic otitis media with perforation of the tympanic membrane and ossicular chain disruption., Cholesteatoma involving the mastoid and middle ear., Trauma to the ear resulting in eardrum perforation and ossicular damage.

Documentation should include the diagnosis, operative report detailing the extent of the procedure, including the type of ossicular chain reconstruction and any other procedures performed, and pre- and postoperative audiograms.