Presentation
Diminished hearing in the right ear following trauma a few months ago. Right ear mixed moderate hearing loss and left ear moderate sensorineural hearing loss at high frequencies.
Patient Data
Right incudomalleolar dislocation.
Otherwise the petrous temporal bone structures are normal with an aerated middle ear cavity and petrous mastoid air cells. The stapes lies within the oval window and there is no inner ear abnormality.
The left petrous temporal bone and contents are normal.
The images show magnified the normal relationship of the malleus and incus in the left ear and the abnormal (dislocated) malleus and incus in the contralateral right ear.
Case Discussion
This is an unusual case of traumatic ossicular chain disruption (right incudomalleolar dislocation) 1.
To use a golf analogy, the 'ball' (the head of malleus) has basically been knocked of the 'tee' (incus).