One of the most intriguing topics in middle ear surgeries is the reconstruction of the conductive mechanism. Continuous research has lead to the gradual improvement in our understanding of design and material used for ossicular implants. But the ideal ossicular implant i.e. one that is biocompatible to enable osseointegration and biostable as well as having appropriate rigidity and weight, still remains elusive. The optimal results in ossicular reconstruction depend not only on the qualities of the prosthesis, but on the environment in which it is placed and the surgical techniques used. The success rate of ossiculoplasty has witnessed remarkable rise in past decades. Invention of binocular operating microscope has been a milestone in improving the success of middle ear surgeries including ossiculoplasty. Here, the authors have thrown light on the disease process affecting the ossicular chain and the prognostic factors affecting the outcome of ossiculoplasty considering postoperative hearing assessment of patients.
