The author has no conflicts of interest to declare.
How I Do It
Version of Record online: 13 JAN 2011
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 3, pages 577–579, March 2011
How to Cite
Nikolaidis, V. (2011), Traumatic dislocation of the incudostapedial joint repaired with fibrin tissue adhesive . The Laryngoscope, 121: 577–579. doi: 10.1002/lary.21427
The author has no financial disclosures for this article.
- Issue online: 18 FEB 2011
- Version of Record online: 13 JAN 2011
- Manuscript Accepted: 27 OCT 2010
- Manuscript Received: 14 SEP 2010
- Hearing loss;
- incudostapedial joint;
- fibrin glue
We present a case of traumatic dislocation of the incudostapedial joint (ISJ) and a simple method for controlled application of the glue using commercial fibrin tissue adhesive. A 26-year-old female presented to our ENT clinic for hearing impairment to her left ear 2 months after a head trauma due to a motorcycle accident. The audiogram revealed a 40- to 50-dB HL conductive hearing loss with a notch configuration in bone conduction curve on the left ear. Computed tomography of the left temporal bone revealed a longitudinal fracture line. An exploratory tympanotomy was performed under general anesthesia. The ISJ was found dislocated while the incus was trapped by the edges of the bony lateral attic wall fracture. A small bony edge that impeded incus movement was removed and a small amount of the glue was precisely applied to the lenticular process of the incus with an angled incision knife. The long process of the incus was firmly pressed over the stapes for 30 seconds with a 90° hook and 60 seconds after the application of the glue the ISJ was repaired. One year after our patient achieved full airbone gap (ABG) closure (ABG, ≤10 dB HL), while she demonstrated overclosure in frequencies 2 and 4 kHz. Fibrin tissue glue allowed safe, rapid, and accurate repair of the ISJ and resulted in an anatomically normal articulation as the mass and shape of the ossicles was preserved. Moreover, our patient achieved full ABG closure. Laryngoscope, 2011