Ossiculoplasty for Malleus Bar with Incudostapedial Disconnection and Fused Incudomalleolar Joint

Malleus bar is an abnormal bony connection between the malleus handle and the posterior wall of the tympanic cavity. We report a patient with a malleus bar and another malformation of the ossicles. An 11-year-old boy presented with hearing impairment since early childhood. Computed tomography (CT) r...

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Bibliographic Details
Published in:Case reports in otolaryngology 2020-07, Vol.2020 (2020), p.1-4
Main Authors: Nakai, Masako, Aiso, Natsumi, Matsuura, Hitomi, Kanazawa, Yuji
Format: Article
Language:English
Subjects:
Bones
Case Report
Case reports
Deformities
Ears & hearing
Medical diagnosis
Otology
Pediatrics
Tomography
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Summary:Malleus bar is an abnormal bony connection between the malleus handle and the posterior wall of the tympanic cavity. We report a patient with a malleus bar and another malformation of the ossicles. An 11-year-old boy presented with hearing impairment since early childhood. Computed tomography (CT) revealed a malleus bar with an incudostapedial disconnection in the right ear. At tympanoplasty, the malleus bar was first identified and removed. A fused malleus-incus, not visible on the preoperative CT, was found intraoperatively. Therefore, the fused malleus-incus was removed; then, the ossicular chain was reconstructed, resulting in an improved postoperative hearing level. On preoperative CT, the disconnected incudostapedial joint had been identified, whereas the fused malleus-incus had not. Given the variations in the malleus bar anomaly of the middle ear, the surgical procedure for ossiculoplasty should be adapted intraoperatively based on any findings not visible on the preoperative CT.
ISSN:2090-6765
2090-6773
DOI:10.1155/2020/8828969