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To the Editor.—A 17-year-old Malaysian boy presented to the Ear, Nose, and Throat Department, University of Malaya, in January 1986 with bilateral nonprogressive poor hearing, which had been present since youth. Examination showed him to have bilateral normal tympanic membranes. Results of a Rinne test were negative bilaterally and the result of a Weber's test was central. Pure tone audiogram confirmed bilateral conductive loss, with an average air-bone gap of 40 dB. Results of tympanometry were normal.
An exploratory tympanotomy, done on the right ear in April 1986, revealed a complete absence of the incus and head of the stapes. The rest of the middle ear and ossicular chain were normal. The middle of the handle of the malleus was dissected subperiosteally and a stainless-steel wire was hooked around it. The other end was crimped to the posterior crura. The air-bone gap was closed to an average of 10
PHANG WEE KEONG, RAJAGOPALAN RAMAN, VIJAY KUMAR KHANIJOW. Congenital Absence of Incus and Head of Stapes. Arch Otolaryngol Head Neck Surg. 1987;113(12):1340. doi:10.1001/archotol.1987.01860120086019