Anomalies of the middle ear.

Malformations of the ossicles in 52 ears of 48 patients were analyzed on the basis of surgical findings. The external meatus of each of these ears was patent. The long process of the incus and the stapes are frequently involved in this series of observations. There are distinct groups of ossicular anomalies, in each of which patients show similar degrees of hearing loss and ossicular findings. These include spindle handle, malleus bar, and dislocated annulus. Spindle handle gets its name from the shape of the malleus handle. There is disconnection between the long process of the incus and the capitulum of the stapes. Malleus bar is a kind of malleus fixation, in which a small bony bar connects the tip of the malleus handle to the posterior wall of the tympanic cavity. In the dislocated annulus, the annulus is dislocated cranially in relation to the middle-ear structures. Anomalies of the ossicle are usually present. Surgical repairs for these conditions are discussed.