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September 1961

Repair of Traumatic Interruption of Ossicular Chain

Arch Otolaryngol. 1961;74(3):347-349. doi:10.1001/archotol.1961.00740030354019

A unilateral, conductive-type hearing loss, with a marked air-bone gap of up to 60 db., and with the tympanic membrane intact, should arouse one's suspicion that there has been an interruption of the ossicular chain.6 This suspicion would be fortified by a history of surgical intervention in the mastoid or middle ear. Besides the now frequently performed tympanotomies for stapes surgery with injury to the ossicular chain, a long-forgotten simple mastoidectomy may have to be blamed for such an interruption of the ossicular continuity. Displacement of the incus in an anterior-inferior direction easily occurs if the antrum and the epitympanic space is not approached with the necessary care when the simple mastoidectomy is performed. Utmost care should be exercised when the curet in this area is used. In the absence of a history of surgical intervention, the differential diagnosis includes congenital abnormalities of the ossicles, subluxation of the incudostapedial

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