An ossicular prosthesis includes a proximal end provided with an open conically helical coil for engaging a first ossicular structure, and a distal bell head, piston, or shoe for engaging a second ossicular structure. A connecting element extends therebetween the two to hold the helical coil structure which engages the second ossicular engagement structure in a preferably fixed relationship. The helical coil defines a plurality of spaced apart adjacent windings, with open spaces between the windings. Each adjacent winding decreases in diameter from the proximal to distal end. The windings of the coil may be adjusted relative to each other in length or angle to fit the anatomy. In accord with a one method of use, the helical coil and optionally other portions of the prosthesis function as an armature or endoskeleton. A cement may be provided over the prosthesis to reconstruct the eroded or missing ossicles.
