Trauma-related ossicular chain disruption is a well-documented cause of conductive hearing loss and typically requiring prosthetic reconstruction. We report a unique case in which fibrotic bridging preserved ossicular function without the need for prosthesis. A 36-year-old male presented with progressive left-sided hearing loss and tinnitus, 3 years postmotorcycle accident. High-resolution temporal bone computed tomography revealed dislocation of the malleus from the incus, with no middle ear fluid or soft-tissue mass. Audiometry showed severe to profound mixed hearing loss on the left side. Intraoperative exploration of the middle ear identified fibrotic bands bridging the incudomalleal joint and surrounding the incudostapedial joint. After the removal of nonfunctional adhesions, ossicular mobility was restored, and reconstruction was deferred. Postoperative audiometry showed improved hearing thresholds to the mild-to-moderate range, with air-bone gap closure of approximately 15 dB. This case highlights a rare instance where fibrotic tissue served as a natural prosthesis, restoring mechanical continuity across dislocated ossicles. It underscores the importance of intraoperative assessment of fibrotic bands, which may in selected cases provide sufficient sound transmission, thus avoiding prosthetic use.
Zin et al. (Thu,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: