History of head trauma and vertigo.
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Evidence of chronic incudomalleolar subluxation. The long process of the incus is pointing in the fossa incudis, with consequent total incudostapedial dislocation. There is also normal loss of the ice cream cone appearance.
Ossicular chain disruption is not uncommon complication following trauma to the head and temporal bone. Meriot et al has identified five types of ossicular injuries following trauma 1:
- incudostapedial joint separation
- incudomalleolar joint separation
- dislocation of the incus
- dislocation of the malleoincudal complex
- stapediovestibular dislocation