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Updated: Jan 24, 2026
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Isolated malleus fixation: A pediatric case series
Kevin Y Zhan1, Jameson K Mattingly1, Oliver F Adunka1
1Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA.
Summary
Isolated malleolar fixation in children is rare but causes conductive hearing loss. Surgical correction significantly improves hearing outcomes, potentially avoiding hearing aids.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Auditory Diagnostics
Background:
- Malleolar fixation is a rare cause of conductive hearing loss in pediatric patients.
- This condition is poorly described in the medical literature for this age group.
Purpose of the Study:
- To review a series of isolated malleus fixation cases in pediatric patients.
- To evaluate the effectiveness of surgical intervention for this condition.
Main Methods:
- Retrospective review of pediatric tympanoplasties over a four-year period.
- Analysis of cases with isolated malleus fixation.
- Paired t-tests to compare pre- and post-operative hearing outcomes.
Main Results:
- Five pediatric cases of isolated malleolar fixation were analyzed.
- Sixty percent showed radiographic evidence of bony fixation on CT scans.
- Surgical correction via transcanal tympanoplasty resulted in significant improvement in air-bone gaps (p=0.005).
Conclusions:
- Isolated pediatric malleolar fixation is an uncommon cause of conductive hearing loss.
- CT scans aid in diagnosis.
- Surgical correction leads to improved hearing, potentially reducing the need for hearing amplification.
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