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. 

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