Ossicular Disruption Pattern after Head Trauma

Abstract

This study was performed to analyze types of ossicular disruption in patients with conductive hearing loss after head trauma. We retrospectively reviewed the high resolution computed tomography (HRCT) scans of 24 cases of ossicular disruption after head trauma (mean age : 20 years, M : F=15 : 9). Ossicular disruption was diagnosed by history, physical examination, and temporal bone HRCT, and confirmed by operative findings. We classified ossicular disruption and observed combined temporal bone fracture. In 24 cases of ossicular disruption confirmed by operative findings, 16 cases had temporal bone fracture. In 16 cases of temporal bone fractures, 15 cases had longitudinal fractures and 1 case had complicated fracture. Incus dislocation was found in 14 cases, of which 12 cases had temporal bone fracture. Maleoincudal joint separation was found in 3 cases, among which 2 cases with temporal bone fracture. Incudostapedial joint separation was found in 5 cases, among which 2 cases with temporal bone fracture. Also, fracture of incus long process was found in 1 case, and stapedial crus fracture was found in 1 case without temporal bone fracture. In conclusion, we found that ossicular disruption could occur with or without temporal bone fracture. Incus dislocation was the most common type of ossicular disruption. Therefore, we suggest that incus has no muscular anchor and has the weakest soft tissue attachment among all ossicles.