The middle ear is an air-filled cavity which is sealed by the eardrum and contains the chain of three small bones called the malleus (hammer), incus (anvil) and stapes (stirrup). The Eustachian tube connects the middle ear to the back of the nose and ventilates it.

Surgery is sometimes possible to improve the hearing. Usually this is possible when there is a problem with the small bones (ossicles) in the middle ear which may be partially removed or replaced. Most ear surgery is microsurgical, performed using an operating microscope to enable the surgeon to view the very small structures of the ear under general anaesthesia. It may be carried out down the ear canal without any incisions if access is adequate.

The stapes (stirrup) bone sometime becomes fixed with new bone growth around its edge so causing hearing loss. Partial removal and drilling a microstapedotomy through the footplate allows a piston to be inserted to contact the fluid of the inner ear. This restores the conduction of vibrations from the ear drum through to the inner ear. Sometimes hearing loss is caused by damage to some of the other ossicles which can be replaced or repaired with artificial prostheses made of titanium, artificial bone-like material or plastic.

If the Eustachian tube becomes blocked in adults, sometimes by a simple cold, fluid builds up in the middle ear causing hearing loss. This fluid can be drained by making a small incision in the ear drum usually under local anaesthetic, draining the fluid and then inserting a grommet (plastic tube) into the ear drum to provide the required ventilation.

Click to download information booklet: Stapedectomy

Click to download information booklet: Grommet Insertion



The North Hampshire ENT Partnership is a team of consultants specialising in a wide spectrum of diseases and disorders that affect the Ear, Nose & Throat (ENT) including snoring and sleep disorders, cosmetic and skin surgery.


Our surgeons provide specialist care by drawing from the 50 plus years of combined NHS experience and the many areas of individual specialist expertise available within the partnership.


Pay now