Malleus to stapes assembly. 
The malleus to stapes assembly is the ideal ossicular reconstruction because of its high degree of success.  Unfortunately, both the malleus and the stapes have to be in good position to use this type of reconstruction making it much less common than other forms of ossiculoplasty.  Over a six year period, 1976-1982, there were 20 such procedures performed, as compared to 85 cases of hemi-incus interposition ossiculoplasty in the same period.  The malleus to stapes assembly technique and indications are described in this report.  Reconstruction results show an 80% air-bone gap closure within 10 dB with an average improved speech reception threshold of 18 dB.