An isolated traumatic fracture of the malleus handle.

Traumatic fracture of the malleus handle without tympanic membrane perforation is a rare incidence. Diagnosis of conductive hearing loss can only be confirmed with manipulation of the ossicles under sedation as computerized tomography is not informative. We present a 39-year-old lady with Q-tip injury when she get sudden phone call.

Fracture of the malleus handle is a rare ossicular injury, and fewer than 50 cases have been reported 1. It is not easy to detect the malleus handle fracture with computerized tomography if there is no displacement or rotation of the fractured fragment. Careful otoscopic manipulation of the ossicles under sedation provides recognition of the fracture. Surgical management is challenging as spontaneous or assisted refixation is difficult due to mobile tympanic membrane 2.

We report a 39‐year‐old lady who had an isolated fracture of the malleus handle without tympanic membrane perforation due to Q‐tip injury (Video S1). Patient had 25 dB conductive hearing loss pronounced at middle and high frequencies. She refused any surgery.

Authorship

SY: reviewed the data and prepared the manuscript.

Conflict of Interest

I hereby declare that I do not have any conflict of interests in the manuscript, including financial, consultant, institutional, and other relationships that might lead to bias or a conflict of interest. This study has no grant or funding.

Video S1. An isolated traumatic fracture of the malleus handle is seen during otoscopic examination. Note that there is no tympanic membrane perforation.

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