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Atypical incus necrosis: a case report and literature review

Published online by Cambridge University Press:  29 October 2007

N Choudhury ,
G Kumar ,
M Krishnan  and
D J Gatland
N Choudhury*
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
G Kumar
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
M Krishnan
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
D J Gatland
Affiliation:
Department of Otolaryngology, Southend University Hospital Foundation Trust, UK
*
Address for correspondence: Ms Natasha Choudhury, 47 Priory Mews, Station Avenue, Prittlewell, Southend SS2 5EP, UK. Fax: 01702 460 489 E-mail: Natashamasood1@aol.com
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Abstract

Objective:

We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis.

Case report:

A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing.

Conclusion:

Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.

Keywords

IncusConductive DeafnessAbnormalities
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1124 - 1126
Copyright
Copyright © JLO (1984) Limited 2008

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