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Atypical incus necrosis: a case report and literature review

Published online by Cambridge University Press:  29 October 2007

N Choudhury ,
G Kumar ,
M Krishnan  and
D J Gatland
N Choudhury*
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
G Kumar
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
M Krishnan
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
D J Gatland
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
*
Address for correspondence: Ms Natasha Choudhury, 47 Priory Mews, Station Avenue, Prittlewell, Southend SS2 5EP, UK. Fax: 01702 460 489 E-mail: [email protected]
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Abstract

Objective:

We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis.

Case report:

A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing.

Conclusion:

Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.

Keywords

IncusConductive DeafnessAbnormalities
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1124 - 1126
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Nomura, Y, Nagao, Y, Fukaya, T. Anomalies of the middle ear. Laryngoscope 1988;98:390–3Google Scholar
2 Tuz, M, Dogru, H, Yasan, H, Doner, F, Yariktas, M. Incus and stapes necrosis associated with diabetes mellitus. J Laryngol Otol 2006;120:1–2CrossRefGoogle ScholarPubMed
3 Watson, C. Necrosis of the incus by the chorda tympani nerve. J Laryngol Otol 1992;106:252–3CrossRefGoogle ScholarPubMed
4 Banerjee, AS, Gleeson, MJ. Mesotympanic sarcoidosis. J Laryngol Otol 2005;119:733–6Google Scholar
5 Lannigan, FJ, O'Higgins, P, McPhie, P. The vascular supply of the lenticular and long processes of the incus. Clin Otolaryngol Allied Sci 1993;18:387–9Google Scholar
6 Alberti, PW. The blood supply of the long process of the incus and the head and neck of stapes. J Laryngol Otol 1965;79:966–70CrossRefGoogle Scholar
7 Lannigan, FJ, O'Higgins, P, McPhie, P. Remodelling of the normal incus. Clin Otolaryngol Allied Sci 1993;18:155–60CrossRefGoogle ScholarPubMed
8 Nasrullah, R, Landry, A, Singh, S, Sklepowicz, M, Herbert, RL. Increased expression of cyclooxygenase 1 and 2 in the diabetic rat renal medulla. Am J Physiol Renal Physiol 2003;285:1068–77Google Scholar
9 Masharani, U, Karam, JH, German, MS. Pancreatic hormones and diabetic mellitus. In: Greenspan, FS, Gardener, DG, eds. Basic and Clinical Endocrinology, 7th edn. New York: McGraw-Hill, 2004;658–746Google Scholar