No abstract available.
Incus* ; Malleus*

Osteomas in the middle ear are very rare. To date, there are 23 cases of osteomas of the middle ear reported in the English literature. Of these, five osteomas arose from the ossicles, but those accompanied by cholesteatoma is extremly rare. There are only two cases that are all congenital cholesteatoma. Ossicular osteoma with primary acquired cholesteatoma has not been reported previously. We present a case of osteoma of the incus accompanied by primary acquired cholesteatoma, which was diagnosed incidentally in the middle ear.
Cholesteatoma ; Ear, Middle ; Incus ; Osteoma

In order to study the effect of middle ear malformations on energy absorbance, we constructed a mechanical model that can simulate the energy absorbance of the human ear based on our previous human ear finite element model. The validation of this model was confirmed by two sets of experimental data. Based on this model, three common types of middle ear malformations,
Ear Ossicles ; Humans ; Incus ; Malleus

OBJECTIVES: The direct acoustic cochlear implant (DACI) is among the latest developments in the field of implantable acoustic prostheses. The surgical procedure requires a mastoidectomy and a posterior-inferior tympanotomy, with access to the facial recess at the level of the oval window, in a complex and lengthy surgical approach. Here, we report a new and considerably shorter surgical approach. METHODS: The new approach involves positioning of artificial incus above the oval window through the superior-anterior tympanotomy. We performed DACI placement in temporal bone specimens (n=5) to assess the feasibility of the new approach. RESULTS: The average time for the DACI implant in the temporal bones was only 112 minutes (range, 94 to 142 minutes) and there was little clinical risk associated with the procedure. Access was easy and drilling was minimal. CONCLUSION: Our approach simplified the surgical procedure and consequently reduced the time required for DACI placement.
Acoustics* ; Cochlear Implants* ; Incus ; Prostheses and Implants ; Temporal Bone*

Humans ; Stapes ; Otosclerosis/surgery* ; Ossicular Prosthesis ; Stapes Surgery ; Incus

PURPOSE: This study was conducted to know the applications and limitations of three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT. MATERIALS AND METHODS: This study examined 25 patients who underwent temporal bone CT using a 16-row detector CT as a result of hearing problems or trauma. The axial CT scan of the temporal bone was performed with a 0.6 mm collimation, and a reconstruction was carried out with a U70u Sharp of kernel value, a 1 mm thickness and 0.5-1.0 mm increments. After observing the ossicles in the axial and coronal images, virtual endoscopy was performed using a three dimensional volume rendering technique with a threshold value of -500 HU. The intra-operative otoendoscopy was performed in 12 ears, and was compared with the virtual endoscopy findings. RESULTS: Virtual endoscopy of the 29 ears without hearing problems demonstrated hypoplastic or an incomplete depiction of the stapes superstructures in 25 ears and a normal depiction in 4 ears. Virtual endoscopy of 21 ears with hearing problems demonstrated no ossicles in 1 ear, no malleus in 3 ears, a malleoincudal subluxation in 6 ears, a dysplastic incus in 5 ears, an incudostapedial subluxation in 9 ears, dysplastic stapes in 2 ears, a hypoplastic or incomplete depiction of the stapes in 16 ears and no stapes in 1 ear. In contrast to the intra-operative otoendoscopy, 8 out of 12 ears showed a hypoplastic or deformed stapes in the virtual endoscopy. CONCLUSION: Volume rendering virtual endoscopy using a multi-row detector CT is an excellent method for evaluation the ossicles in three dimension, even though the partial volume effect for the stapes superstructures needs to be considered.
Ear ; Endoscopy* ; Hearing ; Humans ; Incus ; Malleus ; Stapes ; Temporal Bone ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Absence of incus is one of the most common ossicular anomalies and also frequently found in chronic otitis media or chornic otitis media with cholesteatoma. Ossiculoplasty with malleus footplate assembly (MFA) can be an excellent option in the above situations. We reviewed our procedures and evaluated the hearing results of ossiculoplasty using the MFA. SUBJECTS AND METHODS: This study retrospectively reviews a series of 32 patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in an academic tertiary referral center. The autologous incus or hydroxyapatite (HA) was used as materials for reconstruction. RESULTS: Thirteen of 32 patients (40.6%) had ossicular chain anomaly, 9 patients (28.1%) had congenital cholesteatoma and 8 patients (25.0%) had chronic otitis media with cholesteatoma and 2 patients (6.3%) had chronic otitis media. The patients with ossicular chain ano-maly showed the greatest air-bone gap (ABG) closure. Overall, postoperative ABG was 17.7+/-11.7 dB at postoperative 6 months and 19.7+/-14.3 dB at postoperative 1 year, compared with preoperative ABG of 37.9+/-9.3 dB. There was no statistical difference of ABG at postoperative 12 months, 24 months between MFA using incus (n=17) and HA (n=15)(p=0.300, and p=0.563). There was no meaningful difference of postoperative ABG between the patients with combined mastoidectomy (n=10) and those without mastoidecmoy (n=22)(p=0.555). No extrusions occurred. CONCLUSIONS: MFA can be an effective option in the case of absent incus expecting good postoperative hearing results.
Cholesteatoma ; Durapatite ; Hearing ; Humans ; Incus ; Malleus ; Ossicular Prosthesis ; Otitis Media ; Retrospective Studies ; Tertiary Care Centers

Middle ear adenoma can be a rare cause of a middle ear mass. These benign tumors can have epithelial and/or neuroendocrine differentiation. In 1976, Hyams was the first to describe a series of these tumors. It is still thought that these tumors are indistinguishable in composition from each other. We report a case of middle ear adenoma, the clinical and pathologic findings of which illustrate the biological behavior of the middle ear. A 17-year-old male presented with a history of recurrent, bloody otorrhea and high-pitched tinnitus. We diagnosed him with congenital cholesteatoma and performed surgery to remove the entire tumor as well as the incus. However, on postoperative pathology examination, we finally diagnosed the tumor as middle-ear adenoma with neuroendocrine differentiation. In the two years following surgery, the patient's adenoma has not recurred, although long-term observation will be required.
Adenoma ; Adolescent ; Cholesteatoma ; Ear Neoplasms ; Ear, Middle ; Humans ; Incus ; Male ; Tinnitus

Various types of ossicular chain interruption may occur in temporal bone fractures. The most common type is incudostapedial joint disruption. Incus is the most vulnerable to traumatic injury as compared with malleus or stapes, because it is suspended only by ligamentous structures and connected to the incudomalleolar and incudostapedial joints. Incus may rarely be pushed through tympanic membrane or pass through a fracture of posterosuperior external auditory canal. However, a case of complete extrusion of incus into the external auditory canal has not been reported. The author presents a rare case of incus extrusion into the external auditory canal with temporal bone fracture after head trauma.
Craniocerebral Trauma* ; Ear Canal* ; Head* ; Incus* ; Joints ; Ligaments ; Malleus ; Skull Fractures ; Stapes ; Temporal Bone ; Tympanic Membrane

In patients with mild to severe hearing loss, conventional hearing aids offer limited benefits and several problems with feedback and cosmesis. Middle ear implants are a feasible option for patients with moderate to severe hearing loss who are unable to achieve adequate benefit from or cannot tolerate hearing aids for various reasons. Here we present a case of middle ear implant surgery using Vibrant Soundbridge with incus vibroplasty technique, and describe the hearing changes during postoperative follow-up.
Follow-Up Studies ; Hearing Aids ; Hearing Loss ; Hearing* ; Humans ; Incus* ; Ossicular Prosthesis