Incudostapedial joint arthroplasty using temporalis fascia/perichondrium ties

Incudostapedial joint dislocation is the most frequently found ossicular chain defect. In these cases reconstitution of joint capsule is important in maintaining joint integrity. But reconstruction of dislocated incudostapedial joint is a challenging procedure as this joint is devoid of any muscular or soft tissue support. Here we describe a technique designed to reposition the incudostapedial joint in its anatomical position using temporalis fascia or perichondrium. Data have been collected and analyzed from 42 patients with incudostapedial joint discontinuity. The fascial ties used for reconstruction of joint capsule ensure a dynamic union of the repositioned incus with stapes, leading to a significant improvement in conductive hearing loss.