Vol.96 No.6 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.6 June 2003
Earpick-Induced Middle Ear Trauma; Stapedial Footplate
Subsided into the Oval Window without Ossicular Chain
Dislocation
Tetsuo Morihana, Kazumasa Kondoh, Hiroshi Nishimura and Shin-ichi Okumura
(Osaka Rousai Hosptal)
Tadashi Kitahara
(Osaka University Hospital)
A 46-year-old male with an earpick-induced trauma in his left ear was referred to our hospital due to profound mixed hearing loss persisting after myringoplasty at another hospital. The preoperative middle ear CT did not demonstrate any ossicular chain dislocation signs. Preoperative tympanometry did not show a clear Ad type, but stapedial reflex was eliminated on the left side. During middle ear surgery, we found the stapedial footplate had subsided and fixed into the oval window, although the ossicular chain seemed to remain intact. After stapedectomy with ossicular reconstruction using Y-shaped cartilage was performed the air-bone gap definitely improved. There have been many reports about ossicular chain dislocation due to earpick-induced trauma, however there have been few reports describing stapedial footplate subsidence into the oval window without ossicular chain dislocation. In the literature, 10-25％ of trauma-induced ossicular chain dislocation may just be stapedial subsidence into the oval window. We conclude as that it is necessary to consider stapedial subsidence when treating middle ear trauma, and that stapedial subsidence on its own should be classified as a pattern of ossicular chain disruption.
Key words : earpick, trauma, stapedial footplate, oval window, ossicular chain