**4.3 Complications**

It is important to distinguish two typologies of complications: one related to the surgical procedure, being inescapably part of it, and the other one as true complications. The surgical procedure implies the disconnection between incus and stapes so that an additional conductive component to the subject's hearing loss is always postoperatively evident. The other aspect regards the need for sacrificing the chorda tympani nerve so that a taste disturbance could be the consequence of it. In this regard, however, only a very limited number of subjects reported a permanent dysgeusia. Finally, it has also to be considered that the need to reconstruct the ossicular chain should an explantation be needed. Among the true complications, the need for explantation occurred in six subjects: for skin dehiscence (one subject), loud noise (one subject), tinnitus (one subject), and hearing threshold deterioration (three subjects). Four subjects required a surgical revision and in about 9% of the cases, a delayed transient facial palsy was observed, with remarks that were object of a previous publication [8].
