When the tiny bones of the middle ear (ossicles) are damaged or malformed, sound can’t travel properly from the eardrum to the inner ear, causing conductive hearing loss. This can be corrected with a procedure called ossicular chain reconstruction. Performed through the ear canal under local or general anesthesia, this outpatient surgery typically takes 30–40 minutes. Depending on the issue, the surgeon may reshape the bone or replace it with a small prosthetic implant to restore hearing.