Conductive hearing loss after head trauma: review of ossicular pathology, management and outcomes.

INTRODUCTION: This paper reviews our experience of ossicular chain injuries following head trauma treated at Groote Schuur Hospital, Cape Town, South Africa.

MATERIALS AND METHODS: We performed a retrospective chart review of all patients with a history of head trauma and a conductive hearing loss who had undergone exploratory tympanotomy. Sixteen patients were included in the study.

RESULTS: Injury was most common at the incudostapedial joint (63 per cent). Disarticulations of the icudostapedial joint were treated with cartilage interposition in all cases. Audiography showed an improvement in 12 of the patients, with an average improvement of 35 dB.

DISCUSSION: We discuss the various options available to the otologist to repair ossicular disruptions after trauma. In this series, cartilage autografts were used in most incudostapedial joint injuries, with excellent closure of the air-bone gap.

CONCLUSION: Cartilage interposition was a very successful method of repairing incudostapedial joint dislocation in this series, at short term follow up.