Abstract
As one of the iatrogenic diseases, a very rare case of incudostapedial joint dislocation by bouginage of Eustachian tube is reported.
A 48 year-old male was treated for otitis media with effusion with polizerization and bouginage of the Eustachian tube. During the bouginage the patient felt severe pain in the ear. Bleeding in the external ear canal followed by a severe hearing loss was noted. Eight months later the patient visited our clinic and audiological examinations revealed a conductive hearing loss of 50 dB with Ad type tympanogram.
Exprolatory tympanotomy revealed a luxation of the incudostapedial joint. The dislocated long crus of the incus was repositioned but a small space remained between the head of stapes and the lenticular process. Consequently, an autogenous bone fragment, trimmed in a suitable from, was inserted in this space.
To establish the possibility of damaging the joint by bouginage, a bougie was inserted through the Eustachian tube of a temporal bone specimen. As a result it was recognized that the bougie reached to the joint directly if it was inserted too deep into the middle ear cavity.
