Ossiculoplasty is performed in the following cases:

1. To improve and maintain the heating quality of a patient with hearing loss due to ossicular chain disruption (loss of alignment between the middle ear ossicles)
2. Cholesteatoma (a non-cancerous skin growth that develops in the middle ear)
3. Otosclerosis (inherited, abnormal bone growth in the middle ear)
4. Myringostapediopexy (a procedure performed to repair the eardrum after perforation

The several signs / symptoms that appear which indicate the requirement of an Ossiculoplasty are - 

• Loss of hearing 
• Ringing in the ears
• Difficulty sleeping
• Excessive fluid from the ear
• Ear pain

1. Physical examination: The patient’s symptoms and overall physical health are evaluated by the doctor.
2. Blood tests and urine tests: These tests help in the evaluation of certain underlying medical conditions.
3. Imaging tests: Tests like x-rays, CT scans, MRI scans, ultrasounds, and PET scans help the doctor in obtaining clear images of the internal body organs and check for the presence of certain underlying medical conditions.
4. Tuning fork evaluation: This test is done to check for damage to the middle ear or inner ear.
5. Tympanometry: The response of the eardrum to pressure changes and abnormalities in the middle ear functions can be checked using this test.
6. Audiology exam: The level of hearing loss present can be checked using this test.

Ossiculoplasty may be performed under local anesthesia, which involves numbing the area of treatment, or general anesthesia, which involves putting the patient to sleep before the procedure.
The surgeon will first gain access to the middle ear using any one of the following methods:

1. Transcanal approach: This procedure involves the elevation of the tympanometry flap by making two incisions or cuts of about 8 mm each. 
The incisions are joined together by making an additional incision in order to make a U-shaped flap. 
The middle ear that contains the ossicle can be reached by the surgeon using instruments via the U-shaped flap.

2. Post auricular approach: 
The surgeon reaches the middle ear in this technique by making an incision behind the ears. 
After reaching the middle ear, the ossicles will be evaluated by the surgeon to check for the presence of any defects.
The surgeon will then decide whether to opt for an autologous transplant (graft obtained from the patient’s own body, usually from the auricular cartilage present in the outermost part of the ear) or artificial reconstruction (synthetic graft), based on the condition of the patient.
The prosthesis used may include total ossicular replacement prosthesis (TORP) or partial ossicular replacement prosthesis (PORP), along with incus replacement or incus interposition prosthesis.

The prosthesis chosen is trimmed to a length such that it matches the thickness of the cartilage cap or shield that lies on the prosthesis platform.
A gelatin-soaked sponge is then placed around the reconstructed ear to provide more prosthesis stability.
After the completion of the procedure, the ear is covered using a waterproof dressing.
The procedure takes about one to two hours to complete.

Ossiculoplasty may lead to the following complications:

1. Tinnitus (ringing sound in the ears)
2. Dizziness
3. Taste disturbances
4. Infection
5. Facial nerve paralysis
6. Fever
7. Infection
8. Improper grafting leading to poor hearing
9. Severe, complete loss of hearing
10. Necrosis (death) of the osseous graft
11. Stapes displacement
12. Disruption of the annular ligament
13. Extrusion or migration of the prosthesis 

1. It is normal to have dull, throbbing pain in the ear after ossiculoplasty.
2. The doctor will prescribe certain painkillers to relieve the discomfort.
3. It is normal to experience a popping or squelching sound in the ear, especially after yawning and chewing.
4. It is normal to have some fluid discharge from the ears for a couple of days after surgery.
5. The patient may occasionally notice traces of blood coming out of the ear for a few days after surgery.
6. The patient usually goes home on the same day of the surgery. However, some patients may need an overnight stay in the hospital.
7. The patient can usually resume work one to two weeks after the surgery.
8. The patient needs to visit the doctor for a follow-up appointment about eight to ten days after ossiculoplasty. The ear dressing is removed during this visit.

Home remedies:

The following remedies following an ossiculoplasty can aid in a quicker and smoother recovery:

1. The patient should take the prescribed medicines and ear drops on time after discharge.
2. The patient should not insert anything into the ear canal except the prescribed antibiotic ear drops.
3. The patient should avoid blowing the nose.
4. If the patient feels like sneezing, he or she should do it with their mouth open.
5. The patient should avoid any water from entering the ear.
6. The patient should avoid flying for about two weeks after surgery.

Benefits:

The various advantages of ossiculoplasty are:

1. High success rate
2. Improvement in hearing
3. Decreases dizziness
4. Improved sleep
5. Improved communication
6. Increase in confidence 

Cost of ossiculoplasty in India- 

The cost of ossiculoplasty in Mumbai is between INR 85,000 to INR 1,75,000.
The cost of ossiculoplasty in Delhi is between INR 75,000 to INR 1,50,000.
The cost of ossiculoplasty in Bangalore is between INR 75,000 to INR 1,50,000.
The cost of ossiculoplasty in Chennai is between INR 70,000 to INR 1,40,000.