[Pathophysiology and treatment results of auditory ossicle damage due to earpick-induced trauma]

We examined 10 ears from 10 patients undergoing ossiculoplasty due to a diagnosis of earpick-induced traumatic ossiculodialysis. Surgical findings induced dialysis of the incudostapedial joint in 5 patients, however, dialysis of this articulation was infrequent. Abnormal stapes were observed in 9 patients, including 6 patients with foot plate invagination. Five patients had a concomitant perilymphatic fistula. Perilymphatic fistula was found in 5 of 6 patients with vertigo but not in patients with tinnitus. It is thought to be difficult to diagnose ossiculodialysis from a tympanogram alone; stapedius reflex could possibly be referred to at diagnosis. The auditory ossicle was reconstructed using the stapes head and foot plate in patients with normal foot plates. In patients with ossicular invagination, the position of the auditory ossicle was reduced and the perilymphatic fistula closed, with ossicular reconstruction as needed. The surgical results were satisfactory, and auditory acuity was improved in 90% of the patients.