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Ossicular fixation caused by bone dust after saccus decompression surgery.

P Martinez Devesa¹, L Michaels, A Wright

¹Royal National Throat, Nose and Ear Hospital, London, UK. pablo@2oto.fsnet.co.uk

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology

|November 20, 2002

Summary

Bone dust from mastoid surgery can cause ossicular fixation, leading to delayed hearing loss. This study highlights the clinical and histologic features of this complication and discusses preventive measures.

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Area of Science:

Otolaryngology
Surgical Pathology

Background:

Bone dust deposition in the middle ear can occur during temporal bone surgery.
Ossicular fixation resulting from bone dust is an underreported complication.

Purpose of the Study:

To detail the clinical and histologic characteristics of ossicular fixation caused by bone dust after mastoid surgery.
To emphasize the risk of bone dust deposition during temporal bone surgery.

Main Methods:

A case report of delayed conductive hearing loss following sac decompression surgery.
Second-look tympanotomy and histologic examination of middle ear tissues.

Main Results:

A patient developed 45 dB conductive hearing loss six months post-surgery.

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Tympanotomy revealed stapes fixation and round window niche occlusion by new tissue.

Histology showed fibrosis and new bone formation in response to bone dust particles.

Conclusions:

High-speed drilling in temporal bone surgery poses a risk of middle ear bone dust deposition.
Preventive strategies for this complication are discussed.