Abstract
A 16-year-old boy was referred to Ehime University Hospital with suspicion of ossicular chain dislocation three days after accidental trauma to his right ear caused by an earpick. He experienced hearing loss and tinnitus immediately after the ear injury. Two hours later, he experienced vertigo with nausea. Otoscopic examination revealed that the long process of the incus had penetrated the tympanic membrane. A pure tone audiogram revealed a mixed hearing loss with an average air conduction threshold of 56 dB. Neither spontaneous nor positional nystagmus was noted. Results of a fistula test were negative. During surgery, fractures of the stapes were noted at the anterior crus and footplate, although perilymphatic leakage was not found. After removal of the fragmented stapes and the dislocated incus, a teflon wire piston was placed on the oval window following coverage with a fascial graft. The wire was fixed to the malleus handle. Postoperatively, dizziness disappeared and the hearing improved to 26 dB.
