The patient was a 45 year old female with a conductive hearing loss in the left ear for last two years. Audiometric testing showed 45 dB air-bone gap. Exploration of the left ear revealed that stapes was mobile and so was the incus, but independently.
The decision was made at the time of surgery to insert a bridge between the lenticular process and the head of the stapes. Since prior preparation had been made for a possible stapedectomy, a cylindrical block made from the shaft of a Teflon piston was inserted between the incudo-stapedial joint. The block was roughly 1 mm in length. Hearing improved to 15 dB one month after the operation.
Other solutions to this problem might include the use of fibrin glue, bone pate or hydroxyapatite paste.
Abstract: A care report and video demonstrates a method of repairing a hyper mobile or disarticulated incudostapedial joint, along with a discussion of alternative techniques.
Author: Jayant K. Watve, Professor and Head, Dept of E.N.T. Rajarshi Chhatrapati Shahu Maharaj Govt. Medical College (RCSMGMC) Kolhapur, India.