Malleus Handle Fracture; A Case Report

Abstract

Although traumatic middle ear lesions are quite common, isolated fracture of the handle of the malleus is extremely rare.
A33-year-old woman presented with hearing loss in the left ear since she had accidentally stabbed herself in the ear with an earpick. Traumatic perforation of the ear drum closed spontaneously on the thirteenth day after onset, however, she complained of a sensation of ear fullness. Hearing test revealed a mild conductive hearing loss on the affected side. A high compliance at tympanometry and absence of stapedial reflex were also found on that side. CT scan showed a suspicious fracture of the handle of the malleus.
Under general anesthesia, exploration of the middle ear was performed. A fracture of the malleus was identified distal to the short process. A small tip of the tragus cartilage was inserted between the fractured handle of the malleus and the long process of the incus. The hearing normalized immediately after surgery.
We also report the usefulness of an ossicular mobility analyzer which was developed in our department to evaluate middle ear function.