Traumatic stapes fracture with rotation and subluxation into the vestibule and pneumolabyrinth

Authors

  • Ash Ederies MBChB,

    1. Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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  • Heng-Wai Yuen MBBS,

    1. Department of Otolaryngology and Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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  • Joseph M. Chen MD,

    1. Department of Otolaryngology and Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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  • Richard I. Aviv MBChB,

    1. Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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  • Sean P. Symons MPH, MD

    Corresponding author
    1. Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, AG31D Toronto, Ontario, Canada M4N 3M5

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Abstract

A 41-year-old man presented after forceful penetrating ear injury. He had incapacitating vestibular symptoms. Computed tomography revealed pneumolabyrinth with a fractured stapes that was >90° rotated and subluxed into the vestibule, such that the crura and capitulum could be seen in the vestibule. Surgical repair reversed the vestibular symptoms, but there was persistent hearing loss. Stapes fractures are unusual and rarely associated with subluxation into the vestibule. When this does occur, there is usually simple footplate depression. This case demonstrates a rare stapes fracture with pneumolabyrinth and >90 degrees stapes rotation, then subluxation into the vestibule. Laryngoscope, 2009

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