Lee Jeon Mi, Lee Hyun Jin
Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ear Nose Throat J. 2025 Apr;104(4):232-236. doi: 10.1177/01455613221106215. Epub 2022 May 31.
We report a rare case of traumatic stapes luxation into the vestibule. A 31-year-old female visited an emergency room with sudden onset of vertigo and conductive hearing loss after accidental penetrating injury to the right ear. Temporal bone computed tomography detected pneumolabyrinth, with a shade of whole intact stapes in the vestibule. Under exploratory tympanotomy, we observed a separated incudostapedial joint, and the stapes was depressed into the vestibule. The stapes was pulled out to the middle ear, and stapedectomy was performed; the crus were cut, the suprastructure was removed, and the fractured footplate and the long process of the incus were connected with a piston wire. The stapes footplate was sealed with soft tissue and surgical glue. Vertigo rapidly subsided after surgery, and hearing was improved to normal range. However, hearing loss at high frequencies was not recovered, probably because of inner ear damage due to the stapes depressed into the vestibule or surgical manipulation within the vestibule. Traumatic ossicular dislocation is not an uncommon occurrence in otolaryngologic practice, but stapes luxation is rare. Here, we report a rare case with successful repair. This report could serve as a basis for proper treatment in similar cases in the future.
我们报告一例罕见的外伤性镫骨脱位至前庭的病例。一名31岁女性因右耳意外穿透伤后突然出现眩晕和传导性听力损失而就诊于急诊室。颞骨计算机断层扫描发现气迷路，前庭内有完整镫骨的影像。在探查性鼓室切开术中，我们观察到砧镫关节分离，镫骨陷入前庭。将镫骨拉回中耳并进行了镫骨切除术；切断镫骨脚，移除上部结构，用活塞钢丝连接骨折的镫骨底板和砧骨长突。用软组织和手术胶封闭镫骨底板。术后眩晕迅速缓解，听力改善至正常范围。然而，高频听力损失未恢复，可能是由于镫骨陷入前庭导致内耳损伤或前庭内的手术操作所致。外伤性听骨链脱位在耳鼻喉科临床实践中并不罕见，但镫骨脱位很少见。在此，我们报告一例成功修复的罕见病例。本报告可为未来类似病例的恰当治疗提供依据。
