Management of incus dislocation by physiological repositioning of the incus

Data have been collected prospectively from 11 patients (12 affected ears) with traumatic disruption of the ossicular chain. Isolated dislocation of the incus is the most common finding in our cases, but two had stapes arch features and two had fractures of the tympanic bone. The most common cause of the injuries was a road traffic accident. We describe a technique designed to reposition the incus in its physiological position. This involves a combination of a tympanotomy and a posterior approach to the attic region. The results in five patients (six ears) treated in this way are presented.