Incudomalleolar joint disruption

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Traumatic head injury one week ago, present with left conductive deafness.

Patient Data

Age: 50 years
Gender: Female

Left ear: there is a complete incudomallear joint disruption, the body of incus is rotated and displaced superiorly.

Case Discussion

The malleus is firmly attached by the tympanic membrane, by the anterior and lateral ligaments of the malleus and by the tensor muscle and tendon of the tympanic membrane. In traumas, usually this bone remains at its position or moves slightly, on the other hand, the incus is not attached to any muscle structure and its ligaments are rather weak.

Temporal bone fracture is a common cause of conductive deafness caused by disruption of the ossicular chain.  

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