PMC7396058_01
Preoperative and postoperative hearing levels: (a) preoperative pure-tone audiometry (PTA) showing bilateral conductive hearing impairment; (b) postoperative PTA showing an improvement in hearing in the right ear.
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Pure-tone audiometry showed an air-bone gap of 42.5 dB in the right ear and 56.3 dB in the left ear (Figure 1).
Axial view of preoperative temporal bone CT: (a) a bony bar from the posterior wall of the tympanic cavity connects to the malleus neck (arrow); (b) the long process of the incus is poorly visualized, suggesting incudostapedial disconnection (arrow).
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Computed tomography (CT) revealed a bony bar connecting the malleus neck to the posterior tympanic wall and a long, thin process of the incus in the right ear (Figure 2).
Intraoperative findings of the right middle ear: (a) the malleus neck connects to the posterior wall of the tympanic cavity via a bony bar (arrow), which is located inside the chorda tympani (arrowhead); (b) the malleus bar is shown by the arrow. The lenticular process of the incus is absent, and the long process is disconnected from the stapes (arrowhead).
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At the right tympanoplasty (see the video in the supplemental files), we found a thick bony bar adjacent to the chorda tympani (Figure 3). The handle and neck of the malleus were disconnected, and the long process of the incus was short and connected to the stapes via fibrous tissue (Figure 3(b)).