Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-28T04:07:11.604Z Has data issue: false hasContentIssue false
  • English
  • Français

Conductive hearing loss after head trauma: review of ossicular pathology, management and outcomes

Published online by Cambridge University Press:  19 May 2008

O J Basson  and
A C van Lierop
O J Basson
Affiliation:
Division of Otolaryngology, University of Cape Town, South Africa
A C van Lierop*
Affiliation:
Division of Otolaryngology, University of Cape Town, South Africa
*
Address for correspondence: Dr A C van Lierop, Division of Otolaryngology, Groote Schuur Hospital, Observatory, 7925, Cape Town, South Africa.Fax: +2721214488865 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

This paper reviews our experience of ossicular chain injuries following head trauma treated at Groote Schuur Hospital, Cape Town, South Africa.

Materials and methods:

We performed a retrospective chart review of all patients with a history of head trauma and a conductive hearing loss who had undergone exploratory tympanotomy. Sixteen patients were included in the study.

Results:

Injury was most common at the incudostapedial joint (63 per cent). Disarticulations of the icudostapedial joint were treated with cartilage interposition in all cases. Audiography showed an improvement in 12 of the patients, with an average improvement of 35 dB.

Discussion:

We discuss the various options available to the otologist to repair ossicular disruptions after trauma. In this series, cartilage autografts were used in most incudostapedial joint injuries, with excellent closure of the air–bone gap.

Conclusion:

Cartilage interposition was a very successful method of repairing incudostapedial joint dislocation in this series, at short term follow up.

Keywords

Middle Ear OssiclesConductive DeafnessTraumaOtologic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 2 , February 2009 , pp. 177 - 181
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Annual Academic Meeting of the South African Society of Otorhinolaryngology, Head and Neck Surgery, 14–17 November 2004, Port Elizabeth, South Africa.

References

1Cremin, MD. Injuries of the ossicular chain. J Laryngol Otol 1969;83:845–62CrossRefGoogle ScholarPubMed
2Reed, AR, Welsh, DG. Secondary injury in traumatic brain injury patients – a prospective study. S Afr Med J 2002;92:221–4Google ScholarPubMed
3Wilson, DP. Temporal bone trauma. Dr. Quinn's Online Textbook of Otolaryngology: Grand Rounds Archive; http://www.utmb.edu/otoref/grnds/GrndsIndex.html [12 March 1997]Google Scholar
4Pedersen, CB, Johansen, LV. Traumatic lesions of the middle ear: aetiology and results of treatment. Clin Otolaryngol 1986;11:93–7Google Scholar
5Mills, R, Starritt, N. Managing of incus dislocation by physiological repositioning of the incus. J Laryngol Otol 2002;116:589–92Google Scholar
6Hough, JVD, Stuart, WD. Middle ear injury in skull trauma. Laryngoscope 1968;78:899–937Google Scholar
7Adamson, RM, Jeannon, JP, Stafford, F. A traumatic ossicular disruption successfully repaired with n-butyl cyanoacrylate tissue adhesive. J Laryngol Otol 2000;114:130–1CrossRefGoogle ScholarPubMed
8Mundada, PS, Dasgupta, KS, Tapadiya, GB. Temporalis fascia assisted ossicular arthroplasty for the dislocated incus: fascial arthroplastic ossiculoplasty. Laryngoscope 2002;112:1699–702CrossRefGoogle ScholarPubMed
9Kuschke, E. Conductive deafness following head injury: repair of a dislocated incudostapedial joint by wiring. S Afr Med J 1969;43:42–4Google Scholar
10Singh, S, Salib, RJ, Oates, J. Traumatic fracture of the stapes suprastructure following minor head injury. J Laryngol Otol 2002;116:457–9Google Scholar
11Iurato, S, Quaranta, A. Malleus-handle fracture: historical review and three new cases. Am J Otol 1999;20:19–25Google ScholarPubMed
12Hams, JP, Butler, D. Recognition of malleus handle fracture in the differential diagnosis of otological trauma. Laryngoscope 1985;95:665–70Google Scholar
13Johnson, DW, Hasso, AN, Stewart, CE, Thompson, JR, Hinshaw, DB. Temporal bone trauma: high resolution computed tomographic evaluation. Radiology 1984;151:411–15Google Scholar
14Swart, ID, Zwillenberg, S, Berger, AS. Acquired disruption of the incudostapedial articulation: diagnosis with CT. Radiology 1989;171:779–81Google Scholar