Start Submission Become a Reviewer

Reading: High resolution CT diagnosis of isolated fracture of the malleus handle.

Download

A- A+
Alt. Display

Images in Clinical Radiology

High resolution CT diagnosis of isolated fracture of the malleus handle.

Authors:

D Volders ,

Department of Radiology, A.Z. St.-Jan Hospital, Brugge, Belgium, BE
X close

Th Somers,

Department of Otolaryngology, A.Z. St.-Augustinus Hospital, Wilrijk, Belgium,, BE
X close

J Casselman

Department of Radiology, A.Z. St.-Jan Hospital, Brugge, Belgium, Department of Radiology, A.Z. St.-Augustinus Hospital, Wilrijk, Belgium, BE
X close

Abstract

We report a case of a 48-year-old woman with a sudden-onset unexplained conductive unilateral hearing loss. There was no improvement after a trial with systemic corticosteroids. On otomicroscopy, the right tympanic membrane showed an abnormal outline of the malleus handle. Pneumatic otoscopy revealed excessive movement of the umbo compared with the lateral process. Audiometric testing showed a conductive hearing loss in the right ear, with an average pure-tone audiometry of air conduction of 40 dB and a maximum air-bone gap of 45 dB at 500 Hz. Tuning fork tests confirmed conductive hearing loss. Tympanometry showed increased compliance in the right ear and an absent ipsilateral stapedial reflex in response to a broad-band stimulus. High resolution computed tomography (CT) imaging of the temporal bone was performed by a high-definition CT system (Discovery CT750 HD®, GE, Hounslow, England). MIP (Maximum Intensity Projection) coronal ultrafine (around 0.1 mm) reconstructions of the malleus revealed a small non-displaced isolated fracture of the malleus handle (Fig. A and B). On the left there was a continuous appearence of the middle ear ossicles. During surgery, the isolated fracture of the right malleus handle was visualised and an ossiculoplasty was performed using a hydroxylapatite bone cement (OtoMimix®, Biomet, Jacksonville, Florida) (Fig. C). Postoperatively, average pure-tone audiometry of air condition improved to 30 dB, and maximum air-bone gap improved to 35 dB at 500 Hz.

How to Cite: Volders D, Somers T, Casselman J. High resolution CT diagnosis of isolated fracture of the malleus handle.. Journal of the Belgian Society of Radiology. 2012;95(1):35. DOI: http://doi.org/10.5334/jbr-btr.570
47
Views
34
Downloads
Published on 01 Jan 2012.
Peer Reviewed

Downloads

  • PDF (EN)

    comments powered by Disqus