W Chien1, M J McKenna, J J Rosowski, S N Merchant. 1. Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA. wadechien@hotmail.com
Abstract
OBJECTIVE: To describe a series of five patients with isolated fracture of the manubrium of the malleus. DESIGN: Retrospective case series. SUBJECTS: Five patients aged 44-64 years with isolated fracture of the manubrium who presented to our institution over a five-year period (2000-2005). RESULTS: All patients presented with a history of digitally manipulating the external auditory canal, leading to the manubrial fracture, which we presume was due to a suction-type mechanism. Otomicroscopy often revealed a break in the smooth contour of the manubrium. All patients had air-bone gaps on audiometry, especially at higher frequencies. Tympanometry showed hypermobility of the tympanic membrane in four patients who were tested. Laser-Doppler vibrometry revealed increased umbo velocity in four out of five patients. Four patients were treated conservatively. One patient underwent exploratory tympanotomy with successful ossiculoplasty. CONCLUSIONS: Isolated fracture of the manubrium is a rare condition which may present as sudden-onset hearing loss after digital manipulation of the external auditory canal. The diagnosis can be made on the basis of otomicroscopy, audiometry, tympanometry and laser-Doppler vibrometry. Conservative treatment is often successful.
OBJECTIVE: To describe a series of five patients with isolated fracture of the manubrium of the malleus. DESIGN: Retrospective case series. SUBJECTS: Five patients aged 44-64 years with isolated fracture of the manubrium who presented to our institution over a five-year period (2000-2005). RESULTS: All patients presented with a history of digitally manipulating the external auditory canal, leading to the manubrial fracture, which we presume was due to a suction-type mechanism. Otomicroscopy often revealed a break in the smooth contour of the manubrium. All patients had air-bone gaps on audiometry, especially at higher frequencies. Tympanometry showed hypermobility of the tympanic membrane in four patients who were tested. Laser-Doppler vibrometry revealed increased umbo velocity in four out of five patients. Four patients were treated conservatively. One patient underwent exploratory tympanotomy with successful ossiculoplasty. CONCLUSIONS: Isolated fracture of the manubrium is a rare condition which may present as sudden-onset hearing loss after digital manipulation of the external auditory canal. The diagnosis can be made on the basis of otomicroscopy, audiometry, tympanometry and laser-Doppler vibrometry. Conservative treatment is often successful.
Authors: Rosemary B Farahmand; Gabrielle R Merchant; Sarah A Lookabaugh; Christof Röösli; Cagatay H Ulku; Michael J McKenna; Ronald K de Venecia; Christopher F Halpin; John J Rosowski; Hideko H Nakajima Journal: Ear Hear Date: 2016 Mar-Apr Impact factor: 3.570
Authors: Krishnamurti M A Sarmento; André Luiz Lopes Sampaio; Tatiana Guthierre Targino Santos; Carlos Augusto Costa Pires de Oliveira Journal: PLoS One Date: 2017-12-21 Impact factor: 3.240