Traumatic ossicle extrusion into the external auditory canal

June 11, 2013
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We report a rare case of incus dislocation into the external auditory canal following a head injury. The patient was a 35-year-old man who presented to the surgical emergency unit with a head injury that he had sustained during a traffic accident. An x-ray of the skull detected a longitudinal fracture of the right temporal bone. The ENT examination revealed the presence of a bony structure and a blood clot in the right external auditory canal. Computed tomography identified a disruption of the ossicular chain, with an incus-like bony shadow in the external canal. The wide opening of the fracture line and the impact of the accident were believed to have pushed the incus through the fracture and into the external canal. The patient was successfully treated with exploratory tympanotomy and ossiculoplasty.


Head trauma can cause damage to the ear and temporal bone, potentially resulting in tympanic membrane perforation, hemotympanum, injury to the ossicular chain or facial nerve, vertigo, and perilymphatic fistula leading to conductive and/or sensorineural hearing loss.1

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