Two Cases of Earpick induced Traumatic Disruption of the Ossicular Chain; Diagnosed after Long Standing Injury

Abstract

Disruption of the ossicular chain by ear pick injury is a cause of conductive or mixed hearing loss. We report two cases treated surgically 25 years or more after such long-standing ear pick injury.
Both patients had previously complained of symptoms other than hearing loss, and eventually consulted us with complaints of hearing disturbances and tinnitus. Review of their medical histories suggested disruption of the ossicular chain by ear pick injury.
The situation of ear pick injury in both patients was considered by the presence of an eardrum scar and ossicular chain lesion.
A lesion in the stapes was present in Case 1 but not in Case 2. Both cases exhibited a positive stapedial reflex.
A review of 38 previously published cases revealed that those treated surgically within one month of injury were frequently associated with vestibular disturbances, and more likely to exhibit perilymphatic fistula. Most cases had lesions of the stapes (70%) and 6 cases (22%) did not exhibit any other ossicular lesions.