Stapes bar

Abstract

A 13-year-old male presented with a three-year history of left-sided hearing loss with no other otologic symptoms or family history of hearing loss. Binocular microotoscopic examination was normal. The audiogram demonstrated a left moderate, rising to mild conductive hearing loss, with a pure tone average of 10 dBHL on the right and 45 dBHL on the left for air conduction, and with air-bone gaps ranging from 15 to 40 decibels. Word recognition was 100 percent bilaterally, and tympanograms were type A. Computerized tomography scan of the temporal bones revealed no temporal bone anomalies. Left middle ear exploration was performed for a presumptive diagnosis of juvenile otosclerosis. Intraoperatively, an osseous bar was identified extending from the pyramidalis process to the stapes capitulum, running superior and parallel to an intact stapes tendon (Fig 1A). The bar was vaporized with an argon laser (Fig 1B), restoring stapes mobility. A six-week postoperative audiogram demonstrated closure of the airbone gap through 3000 Hz, with a left ear pure tone average of 13 dBHL.