Congenital incus fixation to the fallopian canal

Area of Science:

• Otolaryngology
• Neurosurgery
• Medical Case Study

Background:

• Congenital ossicular chain anomalies are rare, with stapes footplate fixation being most common.
• Isolated incus fixation is exceptionally rare, with limited literature documenting such cases.
• Conductive hearing loss with normal clinical findings often suggests otosclerosis.

Purpose of the Study:

• To report a unique case of isolated incus fixation.
• To describe the surgical management of this rare anomaly.
• To emphasize the importance of considering rare congenital conditions.

Main Methods:

• A surgical case of a woman in her 50s with left-sided conductive hearing loss.
• Intraoperative finding of isolated incus fixation to the fallopian canal.
• Surgical release of fixation and autologous bone grafting at the incostapedial joint.

Main Results:

• Successful surgical separation of the incus from the fallopian canal.
• Placement of an autologous bone graft to reconstruct the incostapedial joint.
• Significant improvement in hearing, with near-complete air-bone gap closure one month post-surgery.

Conclusions:

• This case presents a rare congenital anomaly mimicking otosclerosis.
• Surgical intervention involving incus release and grafting can effectively treat isolated incus fixation.
• Highlights the need for considering unusual ossicular anomalies in conductive hearing loss.