Postinflammatory Fixation of the Malleus: Its Surgical Correction

During the recent "Second Workshop on Reconstructive Middle Ear Surgery," malleus fixation as a cause of conductive hearing loss was briefly discussed. House1and Hough2mentioned it as a complicating factor in stapes surgery. Guilford3showed photographs of excised mallei with bony changes and discussed his experiences with 16 cases. In three of these, no other fixation of the ossicular chain was present. He pointed out that stapedectomy would be useless for these patients. In his comprehensive study of the history and pathology in a series of 116 temporal bones, Ojala4found a case of malleus fixation. His published photomicrograph shows that the malleus is being fixed by new bone formation from the surrounding walls of the epitympanum. A case of fixation of the stapes due to chronic otitis media has been reported by Hallpike and Harrison.5 When we recently had the opportunity to take