This treatment is considered when there is a break in the communication between the 3 bones of hearing. This results in sounds being less well amplified and transferred to the inner ear, causing hearing loss.

In most cases surgery can be completed through the ear hole itself. In a few cases a small cut will need to be placed around the ear hole or behind the ear.

Surgery involves lifting the ear drum to gain access to the middle ear (where the 3 bones of hearing are housed). The exact site(s) of the problem is/are identified.

If one of the bones become stuck to the surrounding walls, it is freed to allow uninterrupted movement in response to sound energy.

If a small gap has formed where two hearing bones are supposed to be in contact, this is reconnected using a bone replacement substance. If a larger gap has formed a purposefully engineered prosthesis may be required.

Success of this surgery depends on the exact nature of the problem(s). On average, 9 out of 10 people gain improvement in their hearing tests following this surgery. The duration of this benefit depends on the nature of the problem addressed. Some people can be permanently fixed whilst others may require repeat procedures.

1 in 5 people complain of a metal taste on the tip of half their tongue following surgery. This is temporary. Permanent change in taste is very rare. If your taste is central to your career (e.g. chef or sommelier) please discuss this with your surgeon.

The effect of this surgery on tinnitus is unpredictable. Many patients report an improvement in their pre-existing tinnitus, some report no change and rarely patients report a deterioration in their tinnitus.

Patients occasionally report temporary balance disturbance following surgery. Permanent change in balance is extremely rare following this surgery.

Patients occasionally report temporary balance disturbance following surgery. Permanent change in balance is extremely rare following this surgery.

This is a minor operation done in an operating theatre whilst the patient is awake but lightly sedated, in most cases. The expert use of local anaesthesia can ensure the procedure is completely pain free. A general anaesthetic can be requested by the patient but has additional risks and increased recovery times.

In most cases the procedure can be completed through the ear hole. Rarely a small and discrete cut needs to be placed around the ear. It takes less than one hour, and patients go home on the same day. Any cuts will be closed with absorbing sutures and covered with glue.

A pack is left in the operated ear for less than 2 weeks to reduce the risk of post-operative infections. Due to the pack, patients often cannot hear effectively from this ear until we remove it in clinic. People who have surgery must keep their ears dry (use cotton wool soaked in vaseline) and avoid rapid air pressure changes (e.g. flights, diving) for the first 2-4 weeks. People traditionally take 1-2 weeks off work depending on the physicality of their job.