Isolated Traumatic Dislocation of the Malleus into the External Auditory Canal

Abstract

We report a rare case of isolated malleus dislocation into the external auditory canal with lateralized intact tympanic membrane following a head trauma. The patient was a 63-year-old woman who presented at the outpatient department of our institute with hearing loss of 10 years’ duration after a bicycle accident. During physical examination of the patient, total dislocation of the malleus-like bony structure into the external auditory canal on the right side was observed. In the computed tomography scan, an isolated malleus dislocation with intact incus-stapes articulation was identified. The patient was successfully treated with endoscopic exploratory tympanotomy and partial ossicular replacement prosthesis. The isolated malleus dislocation can rarely occur after trauma. A careful diagnostic step through history, physical examination, and temporal bone computed tomography scan are needed to confirm this rare condition.

Two Cases of Multiple Ossicular Chain Disruption After Penetrating Injury and Tympanic Membrane Healing

“…The malleus is the ossicle that is more firmly attached, and the TM, tensor tympani tendon, and anterior and lateral mallear ligaments anchor it [7]. The MI joint is additionally shielded within the epitympanic recess [6,9]. In our cases, the two joints were dam-aged by penetrating injuries, but there was no damage to the inner ear because the footplate was preserved.…”

“…Among several types of ossicular injuries, IS dislocation is the most frequent ossicular chain disruption following head trauma [6][7][8]. The malleus and stapes are more resistant to disarticulation or severe injuries than the incus.…”