목적: Malleus-footplate assembly or long collumelization can be performed to reconstruct discontinued ossicular chain in patients having conductive hearing loss due to stapes supra-structure missing with mobile stapes footplate. Among these patients, incus-footplate assembly (IFA) was attempted in a very limited number of patients in which incus long process was preserved. In this study, authors reviewed surgical findings and analyzed hearing outcomes. 방법:Eight patients (4 male patients) who underwent IFA at Seoul National University Hospital and Seoul National University Bundang Hospital from 2005 to 2014 were included in this study. The patients’ mean age was 29.3 years old (range, 11 - 61) and follow-up duration ranged from 12.1 to 60.1 months. Hearing improvements were evaluated by post-operative air-bon gap (ABG) and ABG closure (post-operative air conduction threshold – pre- operative bone conduction threshold). Causes of conductive hearing loss and intraoperative findings were reviewed. 결과:Causes of stapes supra-structure missing and conductive hearing loss were congenital ossicular anomaly (N=5), congenital cholesteatoma (N=1), and chronic otitis media (N=2). The mean pre-operative ABG and the mean postoperative ABG were 38.3 ± 4.8 dB and 13.3 ± 10.0 dB, respectively. The postoperative ABGs for each frequency, 0.25, 0.5, 1.0, 2.0, 3.0, and 4.0 kHz, were 20.0 ±15.4, 16.9 ± 11.9, 16.3 ± 10.3, 10.6 ± 7.3, 12.9 ± 14.0, 23.1 ± 16.2, respectively. The mean ABG closure was 9.5 dB (range, -1.3 – 35.8 ). The ‘best results’ (mean ABG closure < 10dB) were 7 cases. In the remaining one patient, mean ABG closure was 9.5 dB until 6 months after surgery, but was 35.8 dB at 1 year after surgery. The mean length of the prosthesis was designed to fit the distance between medial side of incus and stapes footplate (3.6 ± 0.5 mm). 결론:IFA seems to be a reasonable surgical option in patients missing stapes supra-structure with intact footplate in which incus long process was preserved.